Medicaid providers in Worthington collected $7,304,658 in 2024 for services under the Procedures / Professional Services category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This amount reflects a 174.7% rise from 2023, when providers submitted $2,658,687 in claims for these services.
Medicaid is a public health insurance program managed by states with joint funding from federal and state governments. It insures low-income people and families, seniors, children, and individuals with disabilities, standing among the largest U.S. health care programs.
Shifts in Medicaid billing levels impact how taxpayer-supported health care dollars are spent locally.
The “Procedures / Professional Services” category encompasses services billed to Medicaid based on the nature of care, grouped by standardized HCPCS and CPT codes. For this evaluation, each billing code is placed in a single service group using established code prefixes and ranges, which enables thorough category analysis without double counting and sustains accurate rankings over time.
Medicaid spending increased across multiple categories this year, but Procedures / Professional Services led all categories in Worthington by total Medicaid payments in 2024.
Statewide, Procedures / Professional Services ranked fifth among all service categories for Medicaid payments in Ohio for 2024.
Between 2019 and 2024, Medicaid payments related to Procedures / Professional Services in Worthington grew by $6,611,185, representing a 953.3% increase. The pace of spending escalated at several points, especially during 2023 and 2022.
Though these services were provided citywide, Medicaid payments for Procedures / Professional Services were concentrated in a small group of ZIP codes. In 2024, ZIP code 43085 accounted for $7,304,657, which represented 100% of related Medicaid payments in Worthington that year.
A limited set of specific billing codes garnered the majority of Medicaid payments within the Procedures / Professional Services group.
Compared to the 174.7% year-over-year growth for Procedures / Professional Services claims in Worthington between 2024 and 2023, spending across all Medicaid categories in the city rose by 66.3% during the same time span.
According to the Centers for Medicare & Medicaid Services, combined Medicaid expenditures from federal and state sources totaled around $871.7 billion in fiscal year 2023. This represented about 18% of total national health expense, up significantly from about $613.5 billion in 2019, prior to the onset of the COVID-19 pandemic.
The approximate 40% growth is attributed in large part to increased enrollment and utilization during and following the pandemic years.
Recent federal budget laws enacted under the Trump administration have included substantial proposals to reduce federal Medicaid contributions and modify the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is estimated to result in over $1 trillion in federal Medicaid cuts over the coming decade, featuring new requirements such as mandatory work verification and higher cost-sharing, which may reduce coverage and funding for certain groups. These moves are expected to increase state financial responsibility and limit further federal Medicaid expansion, even as millions continue to depend on the program nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $693,472 | -24.6% |
| 2021 | $753,142 | 8.6% |
| 2022 | $1,020,254 | 35.5% |
| 2023 | $2,658,686 | 160.6% |
| 2024 | $7,304,657 | 174.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Procedures / Professional Services | $7,304,657 | 28.6% |
| 2 | National Codes Established for State Medicaid Agencies | $6,346,728 | 24.9% |
| 3 | Anesthesia | $4,878,281 | 19.1% |
| 4 | Alcohol and Drug Abuse Treatment | $3,530,773 | 13.8% |
| 5 | Durable Medical Equipment | $1,361,142 | 5.3% |
| 6 | Medicine Services and Procedures | $633,408 | 2.5% |
| 7 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $515,371 | 2% |
| 8 | Evaluation and Management | $400,056 | 1.6% |
| 9 | Surgery | $363,610 | 1.4% |
| 10 | Medical And Surgical Supplies | $84,397 | 0.3% |
| 11 | Ambulance and Other Transport Services and Supplies | $57,595 | 0.2% |
| 12 | Dental Services | $28,806 | 0.1% |
| 13 | Enteral and Parenteral Therapy | $8,241 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G9654 | Mon anesth care | $4,867,500 | 111 |
| G0156 | Hhcp-svs of aide,ea 15 min | $1,284,053 | 33 |
| G0300 | Hhs/hospice of lpn ea 15 min | $570,495 | 22 |
| G0299 | Hhs/hospice of rn ea 15 min | $445,209 | 37 |
| G0151 | Hhcp-serv of pt,ea 15 min | $103,747 | 21 |
| G0152 | Hhcp-serv of ot,ea 15 min | $33,650 | 7 |
| G9002 | Mccd,maintenance rate | $0 | 42 |
| G9006 | Mccd, home monitoring | $0 | 133 |
| G9009 | Mccd, risk adj, level 3 | $0 | 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.
