In 2024, Medicaid providers in Wyomissing submitted $1,761,809 in claims for services under the Alcohol and Drug Abuse Treatment category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 14.7% rise from 2023, during which total claims for this care type reached $1,536,468.
Medicaid, a public insurance initiative managed by states and funded through a partnership between federal and state governments, supports low-income families and individuals, seniors, children, and those with disabilities, making it a major component of the national health care system.
Because taxpayer funding supports Medicaid payments, trends in billing at the local level highlight how health care funds are distributed within a community.
The “Alcohol and Drug Abuse Treatment” service group encompasses medical claims, organized according to standardized HCPCS and CPT code definitions. Each billing code in this review was assigned to a single service category based on shared code prefixes and specific number ranges. This structure allowed the analysis of related treatments together while maintaining distinct rankings and preventing double counting.
Although spending increased in multiple service categories, Alcohol and Drug Abuse Treatment ranked as the third-largest by total Medicaid expenditures in Wyomissing during 2024.
Statewide in Pennsylvania, Alcohol and Drug Abuse Treatment was the top Medicaid payment category in 2024.
From five years before 2024 through the year itself, Medicaid spending in Wyomissing attributed to Alcohol and Drug Abuse Treatment grew by $1,224,916, an increase of 228.1%. Notable spending surges were recorded in 2022 and 2023 as part of this broader trend.
While these Medicaid payments covered care delivered across Wyomissing, most payments for the Alcohol and Drug Abuse Treatment category originated in a small number of ZIP codes. In 2024, ZIP code 19610 tallied $1,761,808 in related Medicaid reimbursements. This ZIP code accounted for 100% of Medicaid spending on Alcohol and Drug Abuse Treatment in Wyomissing that year.
Within this service group, a handful of individual billing codes accounted for most of the Medicaid reimbursement.
In comparison with the previous year, Medicaid payments connected to Alcohol and Drug Abuse Treatment services in Wyomissing rose by 14.7% from 2023 to 2024. By contrast, claims across all Medicaid categories in the city saw a 12.4% increase for the same time frame.
Centers for Medicare & Medicaid Services data show that combined Medicaid spending at the federal and state levels reached approximately $871.7 billion in fiscal year 2023, which made up about 18% of national health expenditures. This represented a significant jump from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This marks nearly 40% growth over several years, driven mainly by growth in enrollment and higher demand for services during and after the pandemic.
Legislation passed under the Trump administration featured proposals to cut federal Medicaid funding and modify its structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid funding by more than $1 trillion across the next 10 years. It also adds requirements such as work mandates and increased cost-sharing, which may reduce access and funding for some enrollees. These changes will likely increase the financial responsibility of states, even as Medicaid continues to cover tens of millions across the country.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $536,892 | – |
| 2021 | $712,747 | 32.8% |
| 2022 | $1,146,246 | 60.8% |
| 2023 | $1,536,467 | 34% |
| 2024 | $1,761,808 | 14.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $8,837,358 | 49.2% |
| 2 | National Codes Established for State Medicaid Agencies | $3,089,834 | 17.2% |
| 3 | Alcohol and Drug Abuse Treatment | $1,761,808 | 9.8% |
| 4 | Evaluation and Management | $1,651,403 | 9.2% |
| 5 | Temporary National Codes (Non-Medicare) | $1,296,669 | 7.2% |
| 6 | Procedures / Professional Services | $468,084 | 2.6% |
| 7 | Vision Services | $381,097 | 2.1% |
| 8 | Dental Services | $168,768 | 0.9% |
| 9 | Surgery | $127,333 | 0.7% |
| 10 | Orthotic Procedures and services | $91,128 | 0.5% |
| 11 | Prosthetic Procedures | $34,862 | 0.2% |
| 12 | Radiology Procedures | $33,211 | 0.2% |
| 13 | Pathology and Laboratory Procedures | $11,952 | 0.1% |
| 14 | Medical And Surgical Supplies | $7,580 | <0.1% |
| 15 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H0015 | Alcohol and/or drug services | $507,580 | 22 |
| H0038 | Self-help/peer svc per 15min | $372,165 | 12 |
| H0032 | Mh svc plan dev by non-md | $279,301 | 12 |
| H2030 | Mh clubhouse svc, per 15 min | $262,002 | 12 |
| H0036 | Comm psy face-face per 15min | $223,020 | 12 |
| H0035 | Mh partial hosp tx under 24h | $77,957 | 2 |
| H2019 | Ther behav svc, per 15 min | $33,514 | 3 |
| H0031 | Mh health assess by non-md | $6,266 | 9 |
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.
