Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows Medicaid providers in Wyomissing billed $468,085 for services under the Procedures / Professional Services category in 2024. This represents a 154.1% jump compared to 2023, when providers billed $184,239 for the same services.
Medicaid is a public health insurance program operated by states and funded in partnership with federal and state governments. The program insures low-income individuals and families, as well as seniors, children and people with disabilities, making it a major component of the U.S. health care system.
Since Medicaid is funded by taxpayers, local payment fluctuations reflect how community health care dollars are distributed.
The “Procedures / Professional Services” classification consists of a set of Medicaid-billed services grouped by the care provided and organized by standardized HCPCS and CPT code groupings. This analysis assigns each billing code to a specific service class using consistent code prefixes and ranges, which supports analysis of related services, avoids double counting, and maintains accurate rankings over time.
While Medicaid spending grew in several service categories, Procedures / Professional Services placed sixth for overall Medicaid payments in Wyomissing for 2024.
Across Pennsylvania, Procedures / Professional Services stood fifth in total Medicaid payments in 2024.
In the five years ahead of 2024, Medicaid payments tied to Procedures / Professional Services in Wyomissing rose by $466,210, or 24,862.8%. Periods of heightened growth included substantial year-over-year increases in 2021 and 2023.
Spending on Procedures / Professional Services in Wyomissing was spread citywide; however, the largest share was concentrated in a small number of ZIP codes. In 2024, ZIP code 19610 was responsible for $468,084 in Medicaid payments for this category, accounting for 100% of related Medicaid expenditures in the city during that year.
Payments within the Procedures / Professional Services category were heavily focused on a select group of individual billing codes.
For comparison, the 154.1% rise in Medicaid payments for Procedures / Professional Services between 2024 and 2023 outpaced the 12.4% increase for all Medicaid claim categories in Wyomissing for the same period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid payments reached approximately $871.7 billion during fiscal year 2023—about 18% of all national health care spending and significantly up from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This increase—roughly 40% over several years—was primarily driven by higher enrollment and greater service utilization through and after the pandemic.
Recent federal budget laws enacted under the Trump administration feature key proposals reducing federal Medicaid funding and restructuring the program. One example, the “One Big Beautiful Bill Act,” passed into law in 2025, is expected to cut federal Medicaid funding by over $1 trillion over a decade, while introducing policies such as work requirements and more cost-sharing, potentially reducing benefits and funding for some Medicaid recipients. These changes could drive more costs to the states and limit federal Medicaid spending growth as the program continues to provide coverage to millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,875 | – |
| 2021 | $19,007 | 913.7% |
| 2022 | $56,991 | 199.8% |
| 2023 | $184,239 | 223.3% |
| 2024 | $468,084 | 154.1% |
| 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 |
|---|---|---|---|
| G0156 | Hhcp-svs of aide,ea 15 min | $456,594 | 11 |
| G0299 | Hhs/hospice of rn ea 15 min | $10,758 | 3 |
| G0283 | Elec stim other than wound | $712 | 2 |
| G0008 | Admin influenza virus vac | $20 | 2 |
| G8510 | Scr dep neg, no plan reqd | $0 | 4 |
| G9920 | Scrning perf and negative | $0 | 2 |
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.
