Johnson City Medicaid providers submitted $285,858 in claims for services under the Medicine Services and Procedures category in 2024, Department of Health and Human Services Medicaid Provider Spending database figures show. This represented a 14.6% rise from 2023, when providers billed $249,339 for the same category of service.
Medicaid is a public health insurance initiative managed by states and jointly funded by federal and state governments according to the Commonwealth Fund. The program covers low-income families and individuals, seniors, children and people with disabilities, making it one of the nation’s largest health care payers.
Since Medicaid payments draw on public funds, shifts in billing patterns reveal how taxpayer dollars are distributed for health care at a community level.
The “Medicine Services and Procedures” classification refers to Medicaid-billed services grouped using standardized HCPCS and CPT code sets. For this review, each billing code was placed within a service category by consistent numeric range and prefix, which enables related services to be tracked together without overlapping or double counting, preserving order over time.
Though spending increased for several Medicaid service categories, Medicine Services and Procedures placed fifth in overall Medicaid spending for Johnson City in 2024.
For all of New York, Medicine Services and Procedures ranked as the third largest Medicaid spending category in 2024.
Looking at the five years ending in 2024, Medicaid payments for Medicine Services and Procedures in Johnson City grew by $126,563—a 79.5% jump. Payments accelerated in select years, notably in 2021 and 2022.
Medicaid spending in the Medicine Services and Procedures category was spread citywide, but heavily concentrated in specific ZIP codes. In 2024, ZIP code 13790 alone accounted for $285,858 in spending. This single ZIP code represented 100% of Medicaid spending for this service category in Johnson City for the calendar year.
Payments were focused on a small subset of billing codes within the Medicine Services and Procedures category.
For context, spending for the Medicine Services and Procedures category in Johnson City increased by 14.6% from 2023 to 2024, while overall Medicaid spending for all service categories in the city rose by 30.1% during the period.
Centers for Medicare & Medicaid Services data show joint federal and state Medicaid spending topped roughly $871.7 billion for fiscal 2023, making up close to 18% of health expenditures nationwide—a substantial rise from $613.5 billion in 2019 ahead of the COVID-19 pandemic.
This jump marks an increase of around 40% over several years, largely attributed to greater enrollment and higher demand during and following the pandemic.
Recent Trump administration budget laws included major proposals to decrease federal Medicaid contributions and reshape the program. The “One Big Beautiful Bill Act,” enacted in 2025, aims to cut more than $1 trillion from federal Medicaid allocation in the next decade while implementing new requirements—such as work obligations and higher out-of-pocket costs—which may shut some beneficiaries out or reduce federal support. This approach is anticipated to increase the cost burden for states and curtail growth of federal Medicaid funding, although the program remains a vital safety net for millions of people in the U.S.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $159,295 | -47% |
| 2021 | $229,417 | 44% |
| 2022 | $242,804 | 5.8% |
| 2023 | $249,339 | 2.7% |
| 2024 | $285,858 | 14.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $2,187,308 | 53.7% |
| 2 | Radiology Procedures | $623,809 | 15.3% |
| 3 | Temporary National Codes (Non-Medicare) | $493,188 | 12.1% |
| 4 | Durable Medical Equipment | $370,531 | 9.1% |
| 5 | Medicine Services and Procedures | $285,858 | 7% |
| 6 | Medical And Surgical Supplies | $43,609 | 1.1% |
| 7 | Pathology and Laboratory Procedures | $33,278 | 0.8% |
| 8 | Orthotic Procedures and services | $21,132 | 0.5% |
| 9 | Surgery | $7,335 | 0.2% |
| 10 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $3,910 | 0.1% |
| 11 | Anesthesia | $2,833 | 0.1% |
| 12 | Procedures / Professional Services | $1,453 | <0.1% |
| 13 | Dental Services | $729 | <0.1% |
| 14 | Vision Services | $603 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90834 | Psytx w pt 45 minutes | $104,581 | 10 |
| 93010 | Electrocardiogram report | $24,560 | 42 |
| 97530 | Therapeutic activities | $23,676 | 8 |
| 90837 | Psytx w pt 60 minutes | $21,929 | 5 |
| 90460 | Im admin 1st/only component | $20,910 | 27 |
| 97113 | Aquatic therapy/exercises | $16,901 | 7 |
| 93306 | Tte w/doppler complete | $16,809 | 17 |
| 92508 | Tx sp lang voice comm group | $16,612 | 8 |
| 97150 | Group therapeutic procedures | $16,570 | 15 |
| 90847 | Family psytx w/pt 50 min | $7,540 | 1 |
| 96413 | Chemo iv infusion 1 hr | $5,107 | 3 |
| 90792 | Psych diag eval w/med srvcs | $4,711 | 4 |
| 95810 | Polysom 6/> yrs 4/> param | $2,116 | 1 |
| 93971 | Extremity study | $1,530 | 6 |
| 96110 | Developmental screen w/score | $1,239 | 7 |
| 95816 | Eeg awake and drowsy | $612 | 1 |
| 93970 | Extremity study | $448 | 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.
