In Everett, Medicaid providers billed $134,712 for services in the Medicine Services and Procedures category in 2024, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was an 11.1% increase from 2023, when the same category saw $121,288 in submitted claims.
Medicaid, a public health insurance initiative overseen by states with both federal and state funding, covers low-income people, seniors, children, and those with disabilities, making it a major part of the U.S. health care system.
With Medicaid funded by taxpayer dollars, shifts in local billing reflect how public health resources are distributed within communities.
The “Medicine Services and Procedures” designation groups together services billed to Medicaid based on specific HCPCS and CPT codes. Each billing code was placed in a single service category for this analysis, using standardized code prefixes and number ranges to group related services, avoid double counting, and maintain consistency over time.
While total Medicaid payments grew across several service types, Medicine Services and Procedures were the second-largest Medicaid-funded service category in Everett in 2024.
Statewide in Pennsylvania, the Medicine Services and Procedures category was the third-largest by total Medicaid payments in 2024.
From 2019 through 2024, Everett’s Medicaid payments for Medicine Services and Procedures rose by $121,239, an 899.9% increase. Growth accelerated at points, with substantial annual jumps seen in 2020 and 2021.
Payments in the Medicine Services and Procedures category were spread across the city but concentrated in a few ZIP codes. In 2024, ZIP code 15537 accounted for $134,711 in Medicaid payments for this category, representing all such payments in Everett for the year.
Medicaid billing in the Medicine Services and Procedures category was also clustered among a small group of individual billing codes.
Comparing 2024 with 2023, Medicaid payments for Medicine Services and Procedures in Everett rose by 11.1%, while the overall increase across all Medicaid claim categories in Everett was 20.4% for the period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending combined totaled about $871.7 billion in fiscal year 2023, accounting for an estimated 18% of total national health spending—an increase from roughly $613.5 billion in 2019, before the COVID-19 pandemic.
This represents approximately 40% growth over several years, with higher enrollment and increased care utilization during and after the pandemic cited as primary drivers.
Recent federal budgeting under the Trump administration featured proposals to reduce federal Medicaid funding and adjust program structure. For instance, the “One Big Beautiful Bill Act,” signed in 2025, is estimated to reduce federal Medicaid spending by more than $1 trillion over the next decade while instituting measures like work requirements and greater cost-sharing, potentially limiting coverage for some beneficiaries and increasing financial responsibility for states. Despite these changes, Medicaid remains essential for tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $13,472 | 5541.8% |
| 2021 | $134,743 | 900.1% |
| 2022 | $80,033 | -40.6% |
| 2023 | $121,288 | 51.5% |
| 2024 | $134,711 | 11.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $435,448 | 55.6% |
| 2 | Medicine Services and Procedures | $134,711 | 17.2% |
| 3 | Ambulance and Other Transport Services and Supplies | $108,519 | 13.8% |
| 4 | Pathology and Laboratory Procedures | $59,295 | 7.6% |
| 5 | Vision Services | $17,467 | 2.2% |
| 6 | National Codes Established for State Medicaid Agencies | $14,160 | 1.8% |
| 7 | Radiology Procedures | $4,947 | 0.6% |
| 8 | Procedures / Professional Services | $4,393 | 0.6% |
| 9 | Temporary National Codes (Non-Medicare) | $3,570 | 0.5% |
| 10 | Surgery | $1,281 | 0.2% |
| 11 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| 11 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90837 | Psytx w pt 60 minutes | $103,562 | 12 |
| 96374 | Ther/proph/diag inj iv push | $18,926 | 41 |
| 96375 | Tx/pro/dx inj new drug addon | $7,570 | 28 |
| 93005 | Electrocardiogram tracing | $2,288 | 20 |
| 90834 | Psytx w pt 45 minutes | $2,155 | 2 |
| 96372 | Ther/proph/diag inj sc/im | $125 | 1 |
| 96361 | Hydrate iv infusion add-on | $83 | 2 |
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.
