West Miami Medicaid providers reported $254,878 in billing for the Medicine Services and Procedures service line in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represents a 14.3% uptick compared to 2023, when agencies filed $222,895 in claims under this same category.
Medicaid is a health insurance program overseen by state authorities and financed through a federal-state partnership. The program serves low-income individuals and families, seniors, children, and individuals with disabilities, making up a major component of the national health care system.
Since Medicaid funding is taxpayer-backed, shifts in local claim volumes offer insight into community-level allocation of public health dollars.
The “Medicine Services and Procedures” group consists of Medicaid claims spanning a well-defined set of care types, based on standardized HCPCS and CPT coding structures. Each billing code is classified into a unique service group through set prefixes and number sequences, streamlining analysis by combining related procedures, avoiding overlap, and maintaining precise rankings over time.
Even with gains across multiple service types, Medicine Services and Procedures ranked as the fourth highest by total Medicaid dollar value in West Miami during 2024.
For Florida as a whole, Medicine Services and Procedures placed fifth among all service categories in Medicaid payments for 2024.
Between 2019 and 2024, Medicaid payments for this service group in West Miami rose by $224,713, or 744.9%. Certain years—including 2020 and 2022—saw especially pronounced annual increases.
Medicaid spending for Medicine Services and Procedures was spread throughout West Miami, but the bulk of the city’s payments concentrated in a small number of ZIP codes. In 2024, ZIP code 33144 reported $254,878 in Medicaid payments for this group, comprising 100% of the total for the category in West Miami during the year.
Within this service group, billing activity was focused on only a select group of codes with the highest payment levels.
Comparatively, Medicaid outlays in West Miami for Medicine Services and Procedures increased 14.3% from 2023 to 2024, while the broader pool of Medicaid claim categories experienced growth of 23.8% in the city over the same time frame.
The Centers for Medicare & Medicaid Services reported that combined Medicaid spending by state and federal entities was about $871.7 billion in fiscal year 2023, accounting for roughly 18% of all U.S. health expenditures, and significantly up from $613.5 billion in 2019 before the onset of the COVID-19 pandemic.
This change amounts to an increase of roughly 40% in a few years, fueled mainly by increased enrollment and greater utilization during and after the pandemic years.
Recent federal budget legislation during the Trump administration featured substantial suggestions to reduce federal outlays to Medicaid and restructure its approach. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to cut more than $1 trillion from federal Medicaid funding in the next decade, while instituting work requirements and heightened cost-sharing that may limit coverage and funds for certain populations. The changes are expected to increase state responsibilities, limit federal Medicaid growth, and affect coverage for many Americans as enrollment remains high.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $30,165 | 143.8% |
| 2021 | $38,651 | 28.1% |
| 2022 | $94,105 | 143.5% |
| 2023 | $222,895 | 136.9% |
| 2024 | $254,878 | 14.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $1,847,050 | 51.6% |
| 2 | Temporary National Codes (Non-Medicare) | $873,890 | 24.4% |
| 3 | National Codes Established for State Medicaid Agencies | $371,985 | 10.4% |
| 4 | Medicine Services and Procedures | $254,878 | 7.1% |
| 5 | Surgery | $208,817 | 5.8% |
| 6 | Medical And Surgical Supplies | $19,324 | 0.5% |
| 7 | Radiology Procedures | $767 | <0.1% |
| 8 | Procedures / Professional Services | $66 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 95165 | Antigen therapy services | $114,298 | 23 |
| 92567 | Tympanometry | $32,577 | 111 |
| 92557 | Comprehensive hearing test | $32,410 | 68 |
| 92504 | Ear microscopy examination | $16,767 | 37 |
| 92588 | Evoked auditory tst complete | $11,552 | 21 |
| 95024 | Iq tests w/allergenic xtrcs | $11,404 | 2 |
| 95115 | Immunotherapy one injection | $10,832 | 33 |
| 95004 | Perq tests w/alrgnc xtrcs | $8,192 | 3 |
| 95117 | Immunotherapy injections | $6,962 | 27 |
| 92550 | Tympanometry & reflex thresh | $5,536 | 19 |
| 97155 | Adapt behavior tx phys/qhp | $2,926 | 1 |
| 92579 | Visual audiometry (vra) | $1,073 | 2 |
| 93000 | Electrocardiogram complete | $344 | 5 |
Note: HCPCS codes are included to provide category context. Totals and rankings in this article are based on standardized service groups and are not broken down by individual billing codes.
The data in this article were sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Source data can be located here.
