Waverly Medicaid spending for procedures and professional services up 126.3% in 2024

Waverly’s Medicaid providers billed a total of $477,269 for Procedures / Professional Services in 2024, the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This figure is 126.3% higher than 2023, when providers reported a total of $210,877 in claims for this service class.

Medicaid is a state-administered public health insurance program financially supported by both federal and state governments. It provides coverage to low-income individuals, families, seniors, children, and people with disabilities. The program represents a major segment of the U.S. health care landscape.

As Medicaid funding is taxpayer-based, shifts in local claim volumes indicate how public health care financing is directed within a given community.

The Procedures / Professional Services category encompasses Medicaid-billed treatments as defined by the care provided and grouped according to standardized HCPCS and CPT codes. For this report, each code was consistently classified into one service category based on established prefixes and numeric ranges, allowing for clear comparisons and ensuring individual services were accurately tracked and ranked by year.

Despite Medicaid outlays increasing in multiple areas, Procedures / Professional Services ranked sixth in total Medicaid reimbursements for Waverly during 2024.

On the statewide level, Procedures / Professional Services placed fifth among Medicaid payment categories in Ohio in 2024.

From five years prior to 2024, Medicaid claims tied to Procedures / Professional Services in Waverly rose by $457,822, or 2354.2%. Notable spikes in spending occurred in 2023 and 2022, further accelerating overall growth during that period.

Although care connected with Procedures / Professional Services occurred throughout Waverly, a small number of ZIP codes saw the majority of payments. In 2024, ZIP code 45690 made up the entirety of such Medicaid spending, with $477,268 in payments, accounting for 100% of the city’s total in this service area that year.

Within the Procedures / Professional Services group, most Medicaid dollars went to a relatively small grouping of specific billing codes.

By comparison, between 2024 and 2023, Waverly’s Medicaid payments for Procedures / Professional Services increased by 126.3%. Over the same period, payments across all Medicaid claim categories in the city rose by 18.4%.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid disbursements reached an estimated $871.7 billion in fiscal year 2023. This represents roughly 18% of total U.S. health expenditures, rising significantly from $613.5 billion in 2019, before the COVID-19 pandemic.

That change marks an approximately 40% gain in spending, influenced primarily by more enrollees and higher usage rates during and after the pandemic.

Federal budget legislation during the Trump administration introduced major initiatives to decrease federal Medicaid support and revamp the program’s structure. The “One Big Beautiful Bill Act,” for example, enacted in 2025, is forecast to cut federal Medicaid spending by over $1 trillion in the next decade and enacts provisions like work requirements and more out-of-pocket costs, which could scale back funding and benefits for some enrollees. These adjustments are set to place more financial responsibility on states and slow expansion of federal Medicaid funding while the program continues to serve tens of millions nationwide.

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.