Providers serving Medicaid patients in Hendersonville reported $5,928,954 in billings for the Medicine Services and Procedures category in 2024, based on the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 5.1% rise from 2023, when claims for the same service type totaled $5,643,090.
Medicaid, a joint federal and state health program, delivers coverage to low-income adults, seniors, children, and those with disabilities, making it a key pillar of the nation’s health care system. Funding is provided through a combination of state and federal support, as outlined by the Commonwealth Fund.
Changes in the levels of Medicaid billing locally reveal how public funds are deployed in community-based health care.
The Medicine Services and Procedures category encompasses a set of services billed to Medicaid and organized by standardized HCPCS and CPT coding. For this report, codes were grouped into single service categories based on code prefixes and ranges, so related services could be analyzed together, with accurate ranking and without overlapping tallies.
Multiple Medicaid service categories saw higher spending, with Medicine Services and Procedures emerging as the second biggest by total Medicaid payments in Hendersonville for 2024.
At the state level, Medicine Services and Procedures ranked third in North Carolina for Medicaid payments by category in 2024.
During the five years preceding 2024, Medicaid payments in Hendersonville linked with this category rose by $1,254,751, an increase of 26.8%. Periods of rapid growth were especially notable in 2020 and 2022.
Distribution of Medicaid spending in the Medicine Services and Procedures category predominantly occurred within a few city ZIP codes. In 2024, ZIP code 28791 led with $2,938,197, followed by 28792 at $2,073,160, and 28739 at $917,595. Altogether, these top 3 ZIP codes represented 100% of related Medicaid payments in the area in 2024.
Within this service category, payments largely went toward a small subset of particular billing codes.
Comparatively, while Medicaid payments tied to this category in Hendersonville rose 5.1% from 2023 to 2024, the growth across all Medicaid claim categories in the city for the same period was 1.5%.
According to the Centers for Medicare & Medicaid Services, the total of federal and state Medicaid spending was about $871.7 billion in fiscal year 2023, accounting for roughly 18% of overall U.S. health spending—a substantial increase from $613.5 billion in 2019, before the COVID-19 pandemic.
This growth of about 40% over several years can primarily be attributed to higher enrollment and an uptick in service use following the pandemic effects.
Recent legislation at the federal level, enacted during the Trump administration, included efforts to curtail federal Medicaid funding and alter program structure. One example, the “One Big Beautiful Bill Act,” was signed into law in 2025 and is expected to trim federal Medicaid funding by more than $1 trillion over 10 years. The policy adds requirements like mandatory work and higher cost sharing, changes that may reduce coverage levels or funds accessible to some Medicaid beneficiaries, placing greater fiscal demands on state budgets as federal support slows—even as millions continue to rely on the Medicaid program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $4,674,202 | 65.3% |
| 2021 | $4,765,737 | 2% |
| 2022 | $5,265,951 | 10.5% |
| 2023 | $5,643,089 | 7.2% |
| 2024 | $5,928,953 | 5.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $10,284,102 | 35.1% |
| 2 | Medicine Services and Procedures | $5,928,953 | 20.2% |
| 3 | National Codes Established for State Medicaid Agencies | $5,425,397 | 18.5% |
| 4 | Alcohol and Drug Abuse Treatment | $4,353,506 | 14.8% |
| 5 | Pathology and Laboratory Procedures | $1,047,954 | 3.6% |
| 6 | Ambulance and Other Transport Services and Supplies | $545,173 | 1.9% |
| 7 | Radiology Procedures | $437,383 | 1.5% |
| 8 | Surgery | $352,579 | 1.2% |
| 9 | Drugs Administered Other than Oral Method | $288,833 | 1% |
| 10 | Temporary National Codes (Non-Medicare) | $165,169 | 0.6% |
| 11 | Procedures / Professional Services | $164,429 | 0.6% |
| 12 | Dental Services | $151,565 | 0.5% |
| 13 | Durable Medical Equipment | $95,599 | 0.3% |
| 14 | Medical And Surgical Supplies | $66,732 | 0.2% |
| 15 | Temporary Codes | $8,538 | <0.1% |
| 16 | Anesthesia | $1,268 | <0.1% |
| 17 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $733 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 97153 | Adaptive behavior tx by tech | $2,329,651 | 11 |
| 99509 | Home visit day life activity | $1,572,129 | 37 |
| 92507 | Tx sp lang voice comm indiv | $342,526 | 35 |
| 97155 | Adapt behavior tx phys/qhp | $298,237 | 11 |
| 90837 | Psytx w pt 60 minutes | $271,500 | 85 |
| 96374 | Ther/proph/diag inj iv push | $124,080 | 91 |
| 90833 | Psytx w pt w e/m 30 min | $107,793 | 60 |
| 96375 | Tx/pro/dx inj new drug addon | $99,325 | 51 |
| 90471 | Immunization admin | $91,898 | 188 |
| 97530 | Therapeutic activities | $90,292 | 33 |
| 92508 | Tx sp lang voice comm group | $88,212 | 10 |
| 90472 | Immunization admin each add | $77,181 | 152 |
| 97156 | Fam adapt bhv tx gdn phy/qhp | $72,397 | 11 |
| 96361 | Hydrate iv infusion add-on | $59,018 | 59 |
| 93005 | Electrocardiogram tracing | $45,278 | 75 |
| 90999 | Unlisted dialysis procedure | $37,567 | 2 |
| 96127 | Brief emotional/behav assmt | $34,268 | 157 |
| 97150 | Group therapeutic procedures | $22,900 | 9 |
| 96131 | Psycl tst eval phys/qhp ea | $18,567 | 5 |
| 90791 | Psych diagnostic evaluation | $15,271 | 8 |
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.
