In 2024, Cleveland Medicaid providers submitted $342,708 in claims for services categorized as Procedures / Professional Services, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents an 11.7% rise over 2023, when $306,881 in claims were filed in this category.
Medicaid operates as a public insurance program managed by states and funded jointly by federal and state governments. Serving low-income families, older adults, children, and individuals with disabilities, it is one of the largest segments of the U.S. health care system.
As Medicaid payments derive from taxpayer dollars, changes in local billing patterns help illustrate the distribution of public health care funding within a community.
The “Procedures / Professional Services” category groups together related Medicaid-billed services using standardized HCPCS and CPT coding. For analytical purposes, service codes were matched to unique categories through consistent code prefixes and numerical ranges, enabling the review of similar services and maintaining accurate comparisons over time while avoiding duplicate counts.
Despite increased Medicaid spending in various categories, Procedures / Professional Services ranked as the seventh-highest category by Medicaid outlays in Cleveland for 2024.
The category took the No. 11 spot in total Medicaid payments across Mississippi for the same year.
Over the five-year period through 2024, Cleveland’s Medicaid expenditures in Procedures / Professional Services rose $172,064—an increase of 100.8%. Particularly sharp upticks occurred in some years, including both 2021 and 2022.
While payments for care in this category were made at multiple locations across the city, the total for 2024 was largely confined to a small number of ZIP codes. The 38732 ZIP code alone reached $342,708, accounting for 100% of the Medicaid payments in this service area citywide.
In addition, payments associated with Procedures / Professional Services were concentrated within a limited set of individual billing codes.
For context, Medicaid payments for Procedures / Professional Services in Cleveland advanced by 11.7% from 2023 to 2024, compared to a 20.4% surge covering all Medicaid claim categories within the city during that timeframe.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid outlays together reached about $871.7 billion in fiscal year 2023. This made up roughly 18% of all national health care expenditures, representing a sharp increase from approximately $613.5 billion in 2019, before the COVID-19 pandemic.
This reflects growth of around 40% within a few years, primarily caused by broader eligibility and higher service usage during and following the pandemic.
Recent federal legislative measures signed under the Trump administration proposed major reductions to federal Medicaid spending and changes to the program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is forecast to trim over $1 trillion in federal Medicaid funds over 10 years and includes provisions such as work requirements and higher cost-sharing, potentially limiting funding and insurance for some enrollees. These adjustments are likely to shift greater fiscal responsibility to states while curbing federal growth, though Medicaid remains critical for millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $170,643 | -31.3% |
| 2021 | $273,613 | 60.3% |
| 2022 | $344,611 | 25.9% |
| 2023 | $306,880 | -10.9% |
| 2024 | $342,708 | 11.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $4,256,863 | 32.1% |
| 2 | Evaluation and Management | $2,653,673 | 2<0.1% |
| 3 | Temporary National Codes (Non-Medicare) | $1,911,299 | 14.4% |
| 4 | Ambulance and Other Transport Services and Supplies | $1,444,147 | 10.9% |
| 5 | Medicine Services and Procedures | $1,261,557 | 9.5% |
| 6 | Pathology and Laboratory Procedures | $471,967 | 3.6% |
| 7 | Procedures / Professional Services | $342,708 | 2.6% |
| 8 | Durable Medical Equipment | $304,521 | 2.3% |
| 9 | Surgery | $210,300 | 1.6% |
| 10 | Radiology Procedures | $200,365 | 1.5% |
| 11 | Dental Services | $157,482 | 1.2% |
| 12 | Vision Services | $25,690 | 0.2% |
| 13 | Medical And Surgical Supplies | $16,052 | 0.1% |
| 14 | Drugs Administered Other than Oral Method | $13,444 | 0.1% |
| 15 | Administrative, Miscellaneous and Investigational | $2,488 | <0.1% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $1,004 | <0.1% |
| 17 | Temporary Codes | $154 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0299 | Hhs/hospice of rn ea 15 min | $133,629 | 20 |
| G0378 | Hospital observation per hr | $105,481 | 10 |
| G0300 | Hhs/hospice of lpn ea 15 min | $95,837 | 11 |
| G0467 | Fqhc visit, estab pt | $3,593 | 7 |
| G0511 | Ccm/bhi by rhc/fqhc 20min mo | $2,191 | 11 |
| G0481 | Drug test def 8-14 classes | $1,830 | 4 |
| G2211 | Complex e/m visit add on | $144 | 7 |
| G0008 | Admin influenza virus vac | $0 | 5 |
| G0010 | Admin hepatitis b vaccine | $0 | 1 |
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.