Reading Medicaid providers charged $554,514 for Dental Services in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represented an increase of 15,797.8% over 2023, when claims for the same services totaled $3,488.
Medicaid is a state-administered public health insurance program funded jointly by federal and state governments. The program covers people with low incomes, including families, seniors, children, and individuals with disabilities, forming a significant part of the nation’s health care system.
Since Medicaid funds are taxpayer dollars, fluctuations in local billing can illustrate how public health resources are distributed within a community.
The Dental Services category consists of procedures grouped by care type as defined through standardized HCPCS and CPT code groupings. For this report, each billing code was matched to a single category using consistent code prefixes and numeric ranges, permitting related procedures to be analyzed together and ensuring no double counting while maintaining accurate service rankings over time.
While Medicaid expenditures increased in several categories, Dental Services placed eighth in Reading for total Medicaid outlays in 2024.
Statewide in Pennsylvania, Dental Services ranked 14th among all Medicaid payment categories for the year.
Over the five years preceding 2024, Medicaid Dental Services claims in Reading grew by $545,633, or 6,143.7%. The rise accelerated at certain intervals, with sharp annual increases seen in 2021 and 2022.
Although payments for Dental Services were disbursed throughout Reading, a relatively small number of ZIP codes concentrated the majority. In 2024, ZIP code 19605 recorded $434,914 in Medicaid dental payments, 19602 had $84,541, and 19607 accounted for $18,555. Combined, these 3 ZIP codes made up 97% of Reading’s Dental Services Medicaid payments for the year.
Within the Dental Services reporting group, a limited set of individual billing codes comprised the bulk of Medicaid payments.
For comparison, while Dental Services Medicaid payments in Reading increased 15,797.8% between 2024 and 2023, the combined growth rate for all Medicaid claim categories in the city over that period was 17.4%.
According to the Centers for Medicare & Medicaid Services, nationwide federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023, making up about 18% of overall national health spending. This is a notable jump from around $613.5 billion in 2019, prior to the COVID-19 pandemic.
This upswing reflects growth of roughly 40% over several years, primarily due to rising enrollment and increased service utilization during and after the pandemic period.
Recent federal budget measures enacted under the Trump administration have included substantial Medicaid cuts and program changes. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid spending by over $1 trillion in the next decade. The legislation also introduces work requirements and higher cost-sharing, which could impact coverage and funding for certain recipients, shifting more financial responsibility to states and limiting federal Medicaid expansion moving forward, while the program continues to serve millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $8,881 | -73% |
| 2021 | $36,401 | 309.9% |
| 2023 | $3,488 | -90.4% |
| 2024 | $554,514 | 15797.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $29,321,311 | 49.4% |
| 2 | Medicine Services and Procedures | $10,800,699 | 18.2% |
| 3 | Alcohol and Drug Abuse Treatment | $7,288,699 | 12.3% |
| 4 | Evaluation and Management | $6,419,940 | 10.8% |
| 5 | Ambulance and Other Transport Services and Supplies | $1,685,631 | 2.8% |
| 6 | Procedures / Professional Services | $1,142,692 | 1.9% |
| 7 | Pathology and Laboratory Procedures | $754,556 | 1.3% |
| 8 | Dental Services | $554,514 | 0.9% |
| 9 | Durable Medical Equipment | $439,997 | 0.7% |
| 10 | Orthotic Procedures and services | $229,861 | 0.4% |
| 11 | Radiology Procedures | $197,080 | 0.3% |
| 12 | Vision Services | $184,871 | 0.3% |
| 13 | Surgery | $140,331 | 0.2% |
| 14 | Medical And Surgical Supplies | $101,758 | 0.2% |
| 15 | Temporary National Codes (Non-Medicare) | $34,152 | 0.1% |
| 16 | Enteral and Parenteral Therapy | $24,905 | <0.1% |
| 17 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $22,042 | <0.1% |
| 18 | Temporary Codes | $1,381 | <0.1% |
| 19 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 19 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| D0120 | Periodic oral evaluation | $142,582 | 73 |
| D0274 | Bitewings four images | $120,770 | 54 |
| D0150 | Comprehensve oral evaluation | $86,381 | 46 |
| D0230 | Intraoral periapical ea add | $61,647 | 42 |
| D0220 | Intraoral periapical first | $45,510 | 52 |
| D0272 | Dental bitewings two images | $33,245 | 38 |
| D0330 | Panoramic image | $25,347 | 7 |
| D0210 | Intraor comprehensive series | $24,092 | 19 |
| D0140 | Limit oral eval problm focus | $9,657 | 23 |
| D0603 | Caries risk assess high risk | $5,280 | 7 |
| D0431 | Diag tst detect mucos abnorm | $0 | 5 |
Note: HCPCS codes are listed to provide context within the category. Totals and category rankings referenced are based on standardized groupings and not individual codes.
This information was sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Source data is available here.
