In 2024, billing data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show that Medicaid providers in Morrisville charged $3,263,806 for services classified under the Medicine Services and Procedures category. This represents a 50.4% increase over 2023, when providers billed $2,169,493 for the same category of care.
Medicaid operates as a state-administered public health insurance program funded through a partnership of federal and state sources. The program serves low-income people, seniors, children, and those with disabilities, making it a key component of the U.S. healthcare system.
Changes in local Medicaid billing reflect how tax-funded healthcare resources are being used in the community.
The “Medicine Services and Procedures” designation indicates a range of services defined by care type, using standard HCPCS and CPT coding systems. For this analysis, billing codes were grouped into one service category based on code prefixes and number ranges. This allowed related services to be analyzed together, avoiding duplicate counting and ensuring consistent ranking.
Medicine Services and Procedures accounted for the second-highest Medicaid spending category in Morrisville in 2024, though multiple categories saw increased spending.
At the state level, Medicine Services and Procedures ranked as the third-largest payment category in North Carolina for 2024.
Between 2019 and 2024, Morrisville’s Medicaid payments for Medicine Services and Procedures rose by $1,870,843, marking a 134.3% increase. Growth quickened during select years, with substantial year-to-year gains noted for 2023 and 2021.
Spending was distributed around the city but mainly focused within a small number of ZIP codes. In 2024, ZIP code 27560 recorded $3,263,805 for the category, accounting for 100% of Medicaid payments for Medicine Services and Procedures in Morrisville that year.
Most Medicaid payments in this category were concentrated in just a few specific billing codes.
In comparison, while Medicine Services and Procedures-related payments in Morrisville grew 50.4% between 2024 and 2023, all Medicaid claim categories citywide saw a 7.2% increase for the same period.
Centers for Medicare & Medicaid Services data show that combined federal and state Medicaid spending reached about $871.7 billion for fiscal year 2023, making up around 18% of total national health costs. That’s up from roughly $613.5 billion in 2019, before the COVID-19 pandemic.
This change marks growth of nearly 40% in a few years, mainly due to higher enrollment and utilization during and following the pandemic.
Recent budget measures during the Trump administration have contained major recommendations to cut federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” for instance, was signed into law in 2025 and is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years. It also brings policy shifts such as work requirements and increased cost-sharing that could narrow coverage and limit funding for some enrollees. These changes are set to push more financial burden onto states and limit federal Medicaid growth, even as the program continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,392,963 | 4.7% |
| 2021 | $1,627,460 | 16.8% |
| 2022 | $1,708,180 | 5% |
| 2023 | $2,169,492 | 27% |
| 2024 | $3,263,805 | 50.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $14,528,401 | 61.7% |
| 2 | Medicine Services and Procedures | $3,263,805 | 13.9% |
| 3 | Pathology and Laboratory Procedures | $2,628,910 | 11.2% |
| 4 | Enteral and Parenteral Therapy | $707,408 | 3% |
| 5 | Temporary National Codes (Non-Medicare) | $653,864 | 2.8% |
| 6 | Radiology Procedures | $438,661 | 1.9% |
| 7 | Procedures / Professional Services | $425,093 | 1.8% |
| 8 | Surgery | $354,226 | 1.5% |
| 9 | Durable Medical Equipment | $208,863 | 0.9% |
| 10 | Alcohol and Drug Abuse Treatment | $87,389 | 0.4% |
| 11 | Dental Services | $84,319 | 0.4% |
| 12 | Medical And Surgical Supplies | $62,892 | 0.3% |
| 13 | National Codes Established for State Medicaid Agencies | $49,089 | 0.2% |
| 14 | Drugs Administered Other than Oral Method | $38,505 | 0.2% |
| 15 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $1,890 | <0.1% |
| 16 | Temporary Codes | $124 | <0.1% |
| 17 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 97530 | Therapeutic activities | $847,873 | 49 |
| 92507 | Tx sp lang voice comm indiv | $701,305 | 59 |
| 97153 | Adaptive behavior tx by tech | $483,761 | 5 |
| 90460 | Im admin 1st/only component | $347,237 | 271 |
| 90792 | Psych diag eval w/med srvcs | $160,793 | 38 |
| 97155 | Adapt behavior tx phys/qhp | $124,821 | 5 |
| 93306 | Tte w/doppler complete | $69,227 | 42 |
| 96372 | Ther/proph/diag inj sc/im | $54,692 | 170 |
| 90837 | Psytx w pt 60 minutes | $52,684 | 15 |
| 96110 | Developmental screen w/score | $44,984 | 221 |
| 95810 | Polysom 6/> yrs 4/> param | $41,935 | 19 |
| 96127 | Brief emotional/behav assmt | $35,672 | 350 |
| 92526 | Oral function therapy | $31,026 | 8 |
| 90471 | Immunization admin | $30,229 | 187 |
| 90656 | Iiv3 vacc no prsv 0.5 ml im | $25,610 | 183 |
| 92523 | Speech sound lang comprehen | $21,510 | 9 |
| 92567 | Tympanometry | $20,655 | 51 |
| 93000 | Electrocardiogram complete | $18,608 | 66 |
| 90791 | Psych diagnostic evaluation | $14,232 | 7 |
| 92557 | Comprehensive hearing test | $13,461 | 33 |
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.
