In 2024, Medicaid providers in Fort Payne submitted billings totaling $2,469,458 for services within the Medicine Services and Procedures category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents a 0.4% uptick from 2023, when $2,459,360 in claims were filed for this service type.
Medicaid is a public health insurance initiative overseen by states and supported through federal and state funding. It offers coverage to low-income people, seniors, children, and individuals with disabilities, making up a significant segment of the U.S. health care landscape.
Since taxpayer dollars finance Medicaid, adjustments in local billing indicate how health care resources are allotted within communities.
The “Medicine Services and Procedures” category consists of a range of Medicaid-billed care types, organized by HCPCS and CPT code groups. This analysis grouped billing codes into exclusive service categories using standardized numeric and prefix assignments, ensuring accurate rankings without overlap or duplication.
The Medicine Services and Procedures category recorded the second highest Medicaid spending in Fort Payne for 2024, amid broader increases across service groups.
Statewide, Alabama ranked this category fourth in Medicaid payouts in 2024.
From five years prior to 2024, Medicaid spending for Medicine Services and Procedures in Fort Payne climbed by $1,391,272, marking a 129% increase. Key surges were noted during 2021 and 2022, which saw larger annual gains.
Although distributed across the area, Medicaid payments in this category were concentrated in specific ZIP codes. In 2024, ZIP code 35967 led with $1,799,316, followed by 35968 at $669,197, and 35960 at $944. These top 3 ZIP codes jointly accounted for 100% of citywide Medicaid spending tied to Medicine Services and Procedures.
A limited number of individual billing codes made up the majority of Medicaid activity within this category.
Comparatively, the 0.4% increase for Medicine Services and Procedures in Fort Payne between 2024 and 2023 was outpaced by a 13.5% rise for all Medicaid spending categories in the city during the same span.
The Centers for Medicare & Medicaid Services reported combined state and federal Medicaid costs at roughly $871.7 billion for fiscal year 2023, comprising about 18% of total U.S. health spending. That figure increased considerably from $613.5 billion in 2019, before the COVID-19 pandemic.
This growth, near 40% over a few years, was largely attributed to rising enrollment and greater service use in and after the pandemic.
Recent federal budget legislation under the Trump administration presented significant cuts to federal Medicaid funds and structural changes. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over ten years, adding policies like work requirements and higher cost-sharing, which may narrow coverage for certain groups. These modifications are anticipated to increase cost burdens on states and slow federal Medicaid growth, though the program continues to assist millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,078,185 | -14.6% |
| 2021 | $1,683,403 | 56.1% |
| 2022 | $2,148,150 | 27.6% |
| 2023 | $2,459,359 | 14.5% |
| 2024 | $2,469,457 | 0.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $6,125,174 | 57.1% |
| 2 | Medicine Services and Procedures | $2,469,457 | 23% |
| 3 | Pathology and Laboratory Procedures | $1,037,907 | 9.7% |
| 4 | Evaluation and Management | $571,067 | 5.3% |
| 5 | Ambulance and Other Transport Services and Supplies | $313,892 | 2.9% |
| 6 | Surgery | $70,302 | 0.7% |
| 7 | Radiology Procedures | $61,548 | 0.6% |
| 8 | Procedures / Professional Services | $17,914 | 0.2% |
| 9 | Drugs Administered Other than Oral Method | $17,658 | 0.2% |
| 10 | Alcohol and Drug Abuse Treatment | $11,474 | 0.1% |
| 11 | Temporary Codes | $10,228 | 0.1% |
| 12 | Dental Services | $7,830 | 0.1% |
| 13 | Durable Medical Equipment | $7,024 | 0.1% |
| 14 | Medical And Surgical Supplies | $3,912 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 97530 | Therapeutic activities | $897,279 | 36 |
| 92507 | Tx sp lang voice comm indiv | $475,828 | 42 |
| 97110 | Therapeutic exercises | $433,575 | 29 |
| 90837 | Psytx w pt 60 minutes | $146,971 | 49 |
| 92014 | Compre oph exam est pt 1/> | $101,531 | 29 |
| 90671 | Pcv15 vaccine im | $44,206 | 49 |
| 92523 | Speech sound lang comprehen | $43,310 | 12 |
| 92004 | Compre oph exam new pt 1/> | $31,227 | 13 |
| 90460 | Im admin 1st/only component | $30,646 | 16 |
| 92340 | Fit spectacles monofocal | $27,918 | 33 |
| 90716 | Var vaccine live subq | $22,217 | 22 |
| 90700 | Dtap vaccine < 7 yrs im | $20,835 | 54 |
| 90651 | 9vhpv vaccine 2/3 dose im | $19,230 | 18 |
| 90713 | Poliovirus ipv sc/im | $18,172 | 48 |
| 97166 | Ot eval mod complex 45 min | $17,710 | 16 |
| 90680 | Rv5 vacc 3 dose live oral | $15,099 | 43 |
| 90648 | Hib prp-t vaccine 4 dose im | $13,745 | 50 |
| 90707 | Mmr vaccine sc | $13,377 | 22 |
| 90847 | Family psytx w/pt 50 min | $12,663 | 6 |
| 92015 | Determine refractive state | $12,618 | 32 |
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.
