Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

DE#43 of 49 states

Delaware Medicaid Spending

Delaware's Medicaid program paid $661.9M across 3 providers from 2018–2024. 10 providers in Delaware are flagged on our risk watchlist. The top procedure code is S5130 (Homemaker service, NOS; per 15 min) at $174.0M.

Total Spending

$661.9M

Total Claims

4.8M

Top Providers

3

Beneficiaries

2.7M

Top Procedure

S5130

$174.0M

Flagged Providers

10

on risk watchlist

Avg Per Provider

$220.6M

across 3 providers

Yearly Spending Trend

Spending by Top Procedures

S5130Homemaker service, NOS; per 15 min$174.0M
T2025Waiver services, NOS; per 15 min$113.1M
T1019Personal care services, per 15 min$69.2M
T2020Day habilitation, waiver; per diem$36.9M
T2016Habilitation, residential, waiver; per diem$27.5M

Top Procedures in Delaware

CodeTotal Paid
S5130

Homemaker service, NOS; per 15 min

$174.0M
T2025

Waiver services, NOS; per 15 min

$113.1M
T1019

Personal care services, per 15 min

$69.2M
T2020

Day habilitation, waiver; per diem

$36.9M
T2016

Habilitation, residential, waiver; per diem

$27.5M
T2040

Financial management, self-directed; per month

$24.6M
99213

Office/outpatient visit, est. patient, low-mod complexity

$13.6M
99472

Subsequent pediatric critical care, per day, age 2-5

$11.6M
99214

Office/outpatient visit, est. patient, mod-high complexity

$9.6M
99283

Emergency dept visit, moderate complexity

$9.4M
T2019

Habilitation, prevocational, waiver; per 15 min

$8.0M
T2014

Habilitation, prevocational, waiver, per hour

$7.7M
99284

Emergency dept visit, high complexity

$7.3M
99233

Subsequent hospital care, per day, high complexity

$6.4M
99392

Preventive medicine, established patient, age 1-4

$6.1M