In 2024, Fairhope Medicaid providers submitted claims totaling $632,875 for services under the Medicine Services and Procedures category, according to data collected by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This sum represented an increase of 28.1% over 2023, when the same category saw $494,124 in billed services.
Medicaid is a state-administered public insurance program, financed through a partnership between federal and state governments. It provides health care coverage to low-income individuals and families, seniors, children, and people with disabilities, making it a major component of the national health care system.
Shifts in the amount billed to Medicaid on a local level show how community health care funding is distributed, since these payments are sourced from taxpayers.
The Medicine Services and Procedures classification includes groups of Medicaid-billed services organized by care type, as defined by standard HCPCS and CPT codes. Each billing code for this analysis was matched to a single service group using set code prefixes and number ranges, facilitating the analysis of related services together while avoiding multiple counts and preserving data accuracy over time.
While Medicaid expenditures increased in several categories, Medicine Services and Procedures finished second in total Medicaid payments made in Fairhope in 2024.
Across Alabama, the Medicine Services and Procedures category placed fourth in terms of total Medicaid payments in 2024.
In the five years preceding 2024, Fairhope saw Medicaid payments in this category grow by $286,274, an 82.6% jump. Sporadic surges in spending occurred during this period, with significant year-over-year gains noted in 2021 and 2022.
The distribution of Medicaid expenditures for Medicine Services and Procedures throughout the city showed payments were most heavily concentrated in a single ZIP code. In 2024, ZIP code 36532 recorded $632,875, making up the entire sum of Medicaid payments in this category in Fairhope during that year.
Payments within the Medicine Services and Procedures category were focused on just a few specific billing codes.
In comparison, Medicaid spending for Medicine Services and Procedures increased by 28.1% in Fairhope from 2023 to 2024, outpacing the 20.7% rise across all Medicaid claim categories locally in the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending climbed to about $871.7 billion in fiscal year 2023, making up nearly 18% of the national health expenditures—up noticeably from $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
The growth amounts to about 40% in just a few years, largely influenced by greater enrollment and utilization through and beyond the pandemic era.
Recent federal budget laws signed under the Trump administration included efforts to decrease federal Medicaid funding and alter how the program is managed. For example, the “One Big Beautiful Bill Act,” became law in 2025 and is expected to reduce federal Medicaid funding by over $1 trillion over 10 years. This legislation brings new measures such as work requirements and higher cost-sharing that may reduce the scope of coverage and funding for certain recipients. As a result, states will likely take on more financial responsibility as the growth of federal Medicaid support slows, while the program continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $346,600 | -28.4% |
| 2021 | $460,359 | 32.8% |
| 2022 | $514,942 | 11.9% |
| 2023 | $494,123 | -4% |
| 2024 | $632,875 | 28.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $2,264,881 | 63.3% |
| 2 | Medicine Services and Procedures | $632,875 | 17.7% |
| 3 | Dental Services | $466,176 | 13% |
| 4 | Pathology and Laboratory Procedures | $101,051 | 2.8% |
| 5 | National Codes Established for State Medicaid Agencies | $74,722 | 2.1% |
| 6 | Radiology Procedures | $12,229 | 0.3% |
| 7 | Temporary National Codes (Non-Medicare) | $10,105 | 0.3% |
| 8 | Vision Services | $7,569 | 0.2% |
| 9 | Medical And Surgical Supplies | $5,475 | 0.2% |
| 10 | Durable Medical Equipment | $1,835 | 0.1% |
| 11 | Surgery | $1,004 | <0.1% |
| 12 | Procedures / Professional Services | $13 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 92014 | Compre oph exam est pt 1/> | $150,366 | 51 |
| 92004 | Compre oph exam new pt 1/> | $110,491 | 35 |
| 97530 | Therapeutic activities | $73,959 | 12 |
| 90460 | Im admin 1st/only component | $48,703 | 23 |
| 92340 | Fit spectacles monofocal | $44,677 | 66 |
| 90677 | Pcv20 vaccine im | $35,077 | 27 |
| 92015 | Determine refractive state | $31,167 | 86 |
| 90461 | Im admin each addl component | $26,374 | 18 |
| 90698 | Dtap-ipv/hib vaccine im | $24,105 | 33 |
| 96127 | Brief emotional/behav assmt | $12,628 | 55 |
| 90651 | 9vhpv vaccine 2/3 dose im | $10,926 | 3 |
| 96110 | Developmental screen w/score | $10,361 | 49 |
| 93010 | Electrocardiogram report | $6,254 | 93 |
| 90680 | Rv5 vacc 3 dose live oral | $6,154 | 8 |
| 90716 | Var vaccine live subq | $5,767 | 5 |
| 90656 | Iiv3 vacc no prsv 0.5 ml im | $5,699 | 15 |
| 90633 | Hepa vacc ped/adol 2 dose im | $4,670 | 9 |
| 92551 | Pure tone hearing test air | $4,623 | 35 |
| 92507 | Tx sp lang voice comm indiv | $4,540 | 3 |
| 90707 | Mmr vaccine sc | $3,298 | 5 |
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.