Jackson Medicaid providers sought $1,249,225 for services classified under the Procedures / Professional Services category in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represented a 22.8% rise from 2023, when $1,017,159 was billed for the same category.
Medicaid is a public health insurance program managed by states and funded jointly by federal and state governments. It serves low-income people and families, seniors, children, and individuals with disabilities, making it one of the largest components of the U.S. health care system.
Because Medicaid payments are funded by taxpayers, fluctuations in local billing levels highlight how health care funding is allocated in different areas.
The “Procedures / Professional Services” category includes multiple Medicaid-billed services grouped based on the nature of care, identified by standardized HCPCS and CPT code ranges. For this report, each billing code was mapped to one service category using uniform code prefixes and numerical groupings, ensuring related services were grouped together without overlap and maintaining consistent ranking comparisons over time.
While Medicaid costs increased across several service categories, Procedures / Professional Services ranked fourth in Jackson for total Medicaid payments in 2024.
Statewide in Ohio, Procedures / Professional Services was the fifth-largest category by payments in 2024.
Across the five years up to 2024, Medicaid payments tied to Procedures / Professional Services in Jackson increased by $176,235, or 12.4%. There were especially strong year-over-year increases in 2023 and 2022.
Although care payments in the Procedures / Professional Services category were distributed across Jackson, most were concentrated in a small number of ZIP codes. In 2024, ZIP code 45640 accounted for all $1,249,225 in Medicaid payments in this category. As a result, the top 1 ZIP code was responsible for 100% of associated Medicaid payments in Jackson for the year.
Within this category, Medicaid payments were focused among a relatively small set of billing codes.
To compare, Medicaid payments for Procedures / Professional Services in Jackson jumped 22.8% from 2023 to 2024, whereas all Medicaid claim types in the city increased by 12.5% in the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending totaled approximately $871.7 billion in fiscal year 2023, making up about 18% of national health expenditures—a sharp rise from around $613.5 billion in 2019, before the COVID-19 pandemic.
This reflects an increase of about 40% in several years, largely because of expanded enrollment and higher utilization during and following the pandemic.
Recent federal budget measures under the Trump administration included proposals to reduce federal Medicaid funding and alter program structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut more than $1 trillion from federal Medicaid funding over the coming decade and implements new requirements such as work obligations and increased cost-sharing. These changes could reduce coverage and funding for certain beneficiaries, shifting more costs to states while limiting federal Medicaid growth, even as the program continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,425,459 | -13.2% |
| 2021 | $1,124,649 | -21.1% |
| 2022 | $926,507 | -17.6% |
| 2023 | $1,017,159 | 9.8% |
| 2024 | $1,249,225 | 22.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $2,671,837 | 27.9% |
| 2 | Medicine Services and Procedures | $1,549,829 | 16.2% |
| 3 | Evaluation and Management | $1,508,299 | 15.7% |
| 4 | Procedures / Professional Services | $1,249,225 | 13% |
| 5 | Radiology Procedures | $959,788 | 1<0.1% |
| 6 | Durable Medical Equipment | $817,455 | 8.5% |
| 7 | Alcohol and Drug Abuse Treatment | $418,860 | 4.4% |
| 8 | Ambulance and Other Transport Services and Supplies | $244,243 | 2.5% |
| 9 | Dental Services | $101,900 | 1.1% |
| 10 | Surgery | $28,594 | 0.3% |
| 11 | Pathology and Laboratory Procedures | $28,080 | 0.3% |
| 12 | Vision Services | $3,083 | <0.1% |
| 13 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $2,118 | <0.1% |
| 14 | Medical And Surgical Supplies | $938 | <0.1% |
| 15 | Drugs Administered Other than Oral Method | $351 | <0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 16 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0156 | Hhcp-svs of aide,ea 15 min | $513,025 | 33 |
| G0463 | Hospital outpt clinic visit | $305,752 | 12 |
| G0299 | Hhs/hospice of rn ea 15 min | $257,795 | 24 |
| G0151 | Hhcp-serv of pt,ea 15 min | $151,238 | 12 |
| G0480 | Drug test def 1-7 classes | $9,974 | 10 |
| G0300 | Hhs/hospice of lpn ea 15 min | $7,473 | 1 |
| G0470 | Fqhc visit, mh estab pt | $3,534 | 4 |
| G0467 | Fqhc visit, estab pt | $431 | 3 |
| G8417 | Calc bmi abv up param f/u | $0 | 9 |
| G8420 | Calc bmi norm parameters | $0 | 3 |
| G8756 | No bp measure doc | $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.
