In 2024, Medicaid providers in Phoenixville billed $898,611 for Procedures / Professional Services, the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. That figure reflects a 185,563.4% rise compared with 2023, when claims for these services totaled $484.
Medicaid—funded jointly by state and federal governments and operated by the states—provides public health insurance coverage for low-income individuals, families, seniors, children, and people with disabilities, making it a cornerstone of the U.S. health care system.
Because Medicaid funding comes from taxpayers, trends in local claims reflect how community public health care dollars are spent.
The “Procedures / Professional Services” designation groups certain Medicaid-billed services according to care type, following standardized HCPCS and CPT coding structures. In compiling this analysis, each code was placed within a single category using code prefixes and number ranges, ensuring services were not counted more than once and enabling meaningful rankings over time.
Though Medicaid expenditures increased in several service areas, Procedures / Professional Services ranked fourth for total Medicaid payments in Phoenixville in 2024.
Statewide, Pennsylvania ranked Procedures / Professional Services as the fifth-largest Medicaid payment category in 2024.
In the five years leading to 2024, Phoenixville Medicaid payments tied to Procedures / Professional Services rose by $744,800, an increase of 484.2%. Spikes in annual growth were noted in 2023 and 2020.
While spending under Procedures / Professional Services was seen throughout Phoenixville, payments largely accumulated in only a few ZIP codes. For 2024, ZIP code 19460 registered $898,610 in payments under this category, comprising 100% of related Medicaid disbursements in the city that year.
Within Procedures / Professional Services, Medicaid payments were particularly concentrated in a small set of specific billing codes.
For added perspective, Medicaid payments for Procedures / Professional Services in Phoenixville grew by 185,563.4% from 2023 to 2024, alongside a 9.7% increase across all Medicaid service categories in the city over the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures reached about $871.7 billion nationwide during fiscal year 2023, making up approximately 18% of total U.S. health spending. That level is well above the approximately $613.5 billion spent in 2019, prior to the COVID-19 pandemic.
This increase—about 40% within several years—has been driven largely by increased enrollment and greater use of medical services during and after the pandemic.
Recent federal budget legislation, including measures signed under the Trump administration, has proposed significant rollbacks of federal Medicaid funding and structural changes to the program. The “One Big Beautiful Bill Act,” enacted in 2025, is set to trim more than $1 trillion from federal Medicaid allocations over the next 10 years. The law introduces new cost-sharing, work requirements, and additional rules that may reduce coverage and funding for some recipients, potentially leading states to assume a larger share of costs as future federal support grows more slowly, even as the program serves millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $153,811 | 558.5% |
| 2021 | $269,183 | 75% |
| 2022 | $63 | -100% |
| 2023 | $484 | 666.2% |
| 2024 | $898,610 | 185482.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Durable Medical Equipment | $3,664,998 | 35.1% |
| 2 | Medical And Surgical Supplies | $1,595,884 | 15.3% |
| 3 | Evaluation and Management | $1,501,006 | 14.4% |
| 4 | Procedures / Professional Services | $898,610 | 8.6% |
| 5 | Medicine Services and Procedures | $808,343 | 7.8% |
| 6 | Radiology Procedures | $526,000 | 5% |
| 7 | National Codes Established for State Medicaid Agencies | $478,380 | 4.6% |
| 8 | Alcohol and Drug Abuse Treatment | $414,627 | 4% |
| 9 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $172,899 | 1.7% |
| 10 | Enteral and Parenteral Therapy | $169,435 | 1.6% |
| 11 | Temporary National Codes (Non-Medicare) | $72,736 | 0.7% |
| 12 | Dental Services | $56,667 | 0.5% |
| 13 | Surgery | $31,242 | 0.3% |
| 14 | Pathology and Laboratory Procedures | $17,958 | 0.2% |
| 15 | Ambulance and Other Transport Services and Supplies | $16,004 | 0.2% |
| 16 | Orthotic Procedures and services | $1,882 | <0.1% |
| 17 | Vision Services | $1,809 | <0.1% |
| 18 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| 18 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0156 | Hhcp-svs of aide,ea 15 min | $898,073 | 9 |
| G2211 | Complex e/m visit add on | $523 | 4 |
| G0123 | Screen cerv/vag thin layer | $14 | 5 |
| G0447 | Behavior counsel obesity 15m | $0 | 6 |
Note: HCPCS codes are shown for context within the category. Category totals and rankings in this article are based on standardized service groupings rather than individual billing codes.
Information in this article was obtained from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data can be found here.
