Fenton providers submitted $427,409 in Medicaid claims for services in the Procedures / Professional Services category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 16.5% increase over 2023, when claims in this category totaled $366,725.
Medicaid is a state-administered health insurance program that is funded jointly by state and federal governments. It provides coverage for people with low incomes, families, seniors, children, and individuals with disabilities, making it a major segment of the U.S. healthcare system.
Because Medicaid draws from public funds, local shifts in billing show how health dollars are allocated within communities.
The Procedures / Professional Services category includes a set of Medicaid-billed services sorted by standardized HCPCS and CPT code groupings and assigned to a single category for this analysis. Each billing code was grouped according to consistent code prefixes and numeric ranges, allowing related care types to be tracked without double counting and ensuring ranking accuracy over time.
While Medicaid payments increased across different service groups, Procedures / Professional Services placed fifth by payment volume in Fenton during 2024.
Statewide in Missouri, the Procedures / Professional Services category also ranked fifth by total Medicaid payments for 2024.
Looking at the five years before 2024, Medicaid payments for Procedures / Professional Services in Fenton rose by $188,661 or 79%. Spending increases were especially pronounced during certain periods, with notable year-to-year jumps in both 2022 and 2021.
Payments for Procedures / Professional Services were distributed citywide but were mostly focused in a small number of ZIP codes. For 2024, ZIP code 63026 had the highest Medicaid payments linked to this category in Fenton, totaling $427,408. The top ZIP code made up 100% of Medicaid payments tied to Procedures / Professional Services in Fenton that year.
Within the Procedures / Professional Services grouping, most Medicaid dollars were tied to just a few billing codes.
Comparatively, while Procedures / Professional Services Medicaid payments in Fenton increased by 16.5% from 2023 to 2024, the total for all Medicaid claim categories in the city changed by 23.7% over the same time frame.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures rose to about $871.7 billion for fiscal year 2023—representing roughly 18% of national health spending and a marked increase from $613.5 billion in 2019, before the COVID-19 pandemic.
This equates to nearly 40% growth in just a few years, mainly due to more enrollees and increased usage during and after the pandemic.
Federal budget measures under the Trump administration included major proposals to decrease Medicaid funding and adjust the structure of the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid spending by over $1 trillion over a decade and add requirements, such as work mandates and higher cost-sharing, that could lower coverage and limit funding for some enrollees. These policy changes shift more financial responsibility to states and are set to constrain the growth of federal Medicaid contributions, even as the program continues to provide coverage for millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $238,748 | -58% |
| 2021 | $301,900 | 26.5% |
| 2022 | $503,956 | 66.9% |
| 2023 | $366,724 | -27.2% |
| 2024 | $427,408 | 16.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $5,681,639 | 47.1% |
| 2 | Pathology and Laboratory Procedures | $3,444,348 | 28.6% |
| 3 | Enteral and Parenteral Therapy | $1,267,131 | 10.5% |
| 4 | Medicine Services and Procedures | $554,809 | 4.6% |
| 5 | Procedures / Professional Services | $427,408 | 3.5% |
| 6 | National Codes Established for State Medicaid Agencies | $329,622 | 2.7% |
| 7 | Temporary National Codes (Non-Medicare) | $113,577 | 0.9% |
| 8 | Surgery | $91,414 | 0.8% |
| 9 | Ambulance and Other Transport Services and Supplies | $49,053 | 0.4% |
| 10 | Durable Medical Equipment | $33,193 | 0.3% |
| 11 | Radiology Procedures | $31,851 | 0.3% |
| 12 | Medical And Surgical Supplies | $22,562 | 0.2% |
| 13 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $6,132 | 0.1% |
| 14 | Pathology and Laboratory Services | $1,915 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0463 | Hospital outpt clinic visit | $359,841 | 138 |
| G0483 | Drug test def 22+ classes | $58,017 | 12 |
| G0299 | Hhs/hospice of rn ea 15 min | $3,755 | 1 |
| G2211 | Complex e/m visit add on | $3,377 | 110 |
| G0480 | Drug test def 1-7 classes | $2,417 | 4 |
| G0439 | Ppps, subseq visit | $0 | 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.