Medicaid Medicine Services and Procedures billing surges 397.7% in Herculaneum in 2024

In 2024, Medicaid providers in Herculaneum billed a total of $128,050 for services labeled under the Medicine Services and Procedures category, according to information from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects a 397.7% jump from the prior year, when $25,730 was submitted for the same services.

Medicaid serves as a government-run insurance program managed individually by each state and funded jointly at the federal and state levels. It provides coverage for low-income families and individuals, seniors, children, and people with disabilities, making it a major component of the U.S. health care infrastructure.

Since Medicaid payments come from public funds, trends in local billing offer insights into how community health care resources are distributed.

The “Medicine Services and Procedures” category encompasses a set of Medicaid-billed services that are classified based on type of care, using recognized HCPCS and CPT coding conventions. Billing codes were assigned exclusively to a single service grouping, following set prefixes and numeric designations. This approach allows for a clear analysis of related services, prevents duplication, and maintains precise rankings over time.

Although spending rose in several service categories, Medicine Services and Procedures was the second-highest by total Medicaid payments in Herculaneum during 2024.

Across Missouri, the Medicine Services and Procedures category placed seventh statewide for overall Medicaid spending in 2024.

Between 2019 and 2024, Medicaid payments for the Medicine Services and Procedures category in Herculaneum grew by $125,787, an increase of 5558.4%. The data shows periods of particularly rapid spending growth, including significant annual increases recorded in both 2022 and 2021.

Spending tied to Medicine Services and Procedures was reported throughout the city, but the largest share was concentrated within a few ZIP codes. In 2024, ZIP code 63048 alone accounted for $128,050. This area represented 100% of Medicaid payments for the category in Herculaneum for the year.

Medicaid billing within the category also centered on a narrow selection of individual codes.

In comparison, the 397.7% increase for Medicine Services and Procedures from 2023 to 2024 in Herculaneum far outpaced the 42.5% rise seen across all Medicaid claim categories in the city during that same period.

According to the Centers for Medicare & Medicaid Services, overall federal and state Medicaid spending was estimated at about $871.7 billion in fiscal year 2023, making up roughly 18% of national health expenditures. This marked a significant increase compared with the $613.5 billion reported in 2019, prior to the COVID-19 pandemic period.

This represents a roughly 40% increase over several years, with much of the growth attributed to higher enrollment and increased usage during and immediately following the pandemic.

Federal budget measures enacted under the Trump administration included proposals for substantial reductions to Medicaid funding at the federal level and program restructuring. The “One Big Beautiful Bill Act,” made law in 2025, is projected to cut more than $1 trillion from federal Medicaid spending over the next decade and introduces changes such as work requirements and additional cost-sharing. These measures could reduce coverage and funding for certain beneficiaries and are expected to place more financial responsibility on states while potentially limiting growth in federal Medicaid funding, even though the program continues to support millions of Americans.

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.