In 2024, Sterling Medicaid providers submitted $1,101,818 in claims for the Medicine Services and Procedures category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure reflects a 97.8% jump over 2023, when the total for these services was $557,138.
Medicaid, a government-run public health insurance initiative, is funded together by federal and state governments. It covers individuals and families with low incomes, seniors, children, and people with disabilities, and represents one of the largest sectors of the U.S. health care landscape.
Because Medicaid funds are sourced from taxpayers, fluctuations in local billing levels illustrate how health care funds are distributed within a community.
The “Medicine Services and Procedures” group includes a range of Medicaid-billed services identified by type of care, using standard HCPCS and CPT code groupings. For this report, each billing code was mapped to one service category using code ranges and prefixes. This method prevents duplicate counts and maintains consistent service rankings over time.
Although payouts increased across several categories, Medicine Services and Procedures was fourth in total Medicaid payments in Sterling for 2024.
Across Virginia, Medicine Services and Procedures also ranked fourth by total Medicaid payments in 2024.
From 2019 through 2024, Sterling’s Medicaid payments for Medicine Services and Procedures grew by $804,598, or 270.7%. Payments went up more quickly in certain years, with large yearly increases in 2021 and 2022.
Within Sterling, most Medicaid payments related to these services were driven by a few ZIP codes. In 2024, the top ZIP codes for Medicaid outlays in this category included 20166, at $830,198, 20165 with $271,337, and 20164 at $282. Combined, these top 3 ZIP codes made up the entire Medicaid total for Medicine Services and Procedures in Sterling during the year.
The Medicine Services and Procedures category also saw most Medicaid payments linked to a limited set of individual billing codes.
For context, Medicaid payments for this category in Sterling rose 97.8% from 2023 to 2024, while all Medicaid claim categories in the city increased by 38.4% in the same time frame.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending climbed to about $871.7 billion in fiscal 2023, making up around 18% of total U.S. health expenditures—up sharply from approximately $613.5 billion in 2019, before the onset of COVID-19.
This marks an increase of about 40% in just several years, led mainly by a broader Medicaid enrollment and higher use of services during and following the pandemic.
Recent federal budget laws under the Trump administration have included major proposals reducing federal Medicaid support and changing the program’s structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to lower federal Medicaid spending by over $1 trillion over the next 10 years, introducing measures such as work requirements and greater cost-sharing. These changes will likely push more financial responsibility onto states and slow overall federal growth, while Medicaid continues to assist tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $297,220 | -11.8% |
| 2021 | $664,523 | 123.6% |
| 2022 | $717,393 | 8% |
| 2023 | $557,138 | -22.3% |
| 2024 | $1,101,818 | 97.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $30,325,166 | 77.1% |
| 2 | Temporary National Codes (Non-Medicare) | $4,166,834 | 10.6% |
| 3 | Alcohol and Drug Abuse Treatment | $2,831,128 | 7.2% |
| 4 | Medicine Services and Procedures | $1,101,818 | 2.8% |
| 5 | Evaluation and Management | $763,453 | 1.9% |
| 6 | Pathology and Laboratory Procedures | $126,944 | 0.3% |
| 7 | Vision Services | $10,776 | <0.1% |
| 8 | Ambulance and Other Transport Services and Supplies | $9,822 | <0.1% |
| 9 | Radiology Procedures | $4,251 | <0.1% |
| 10 | Procedures / Professional Services | $2,935 | <0.1% |
| 11 | Surgery | $18 | <0.1% |
| 12 | Dental Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 97110 | Therapeutic exercises | $235,867 | 24 |
| 92507 | Tx sp lang voice comm indiv | $161,090 | 22 |
| 92014 | Compre oph exam est pt 1/> | $159,206 | 33 |
| 97530 | Therapeutic activities | $105,452 | 22 |
| 92083 | Extended visual field xm | $77,677 | 33 |
| 97112 | Neuromuscular reeducation | $66,925 | 12 |
| 90837 | Psytx w pt 60 minutes | $66,831 | 13 |
| 92250 | Fundus photography w/i&r | $60,378 | 33 |
| 92004 | Compre oph exam new pt 1/> | $52,079 | 27 |
| 92609 | Use of speech device service | $38,308 | 9 |
| 92015 | Determine refractive state | $33,045 | 47 |
| 96130 | Psycl tst eval phys/qhp 1st | $19,240 | 51 |
| 97140 | Manual therapy 1/> regions | $12,721 | 11 |
| 92081 | Limited visual field xm | $6,772 | 12 |
| 92523 | Speech sound lang comprehen | $2,218 | 2 |
| 90833 | Psytx w pt w e/m 30 min | $2,070 | 2 |
| 97162 | Pt eval mod complex 30 min | $1,460 | 2 |
| 96372 | Ther/proph/diag inj sc/im | $282 | 2 |
| 90785 | Psytx complex interactive | $188 | 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.
