Summersville Medicaid providers billed $224,267 for Radiology Procedures services in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This amount represents a 2.5% increase compared with 2023, during which providers submitted $218,820 in claims for this service category.
Medicaid, a public health insurance program operated by individual states and funded jointly by federal and state sources, provides coverage for low-income people and families, seniors, children, and people with disabilities. This program stands as one of the most substantial components of the U.S. health care system.
Since Medicaid relies on taxpayer funding, changes in billing reflect how public health care resources are distributed locally.
The “Radiology Procedures” category includes a defined selection of Medicaid-billed services, grouped by the type of care according to standardized HCPCS and CPT codes. For this review, each billing code was allocated to a single service category using specific code prefixes and numeric ranges, which enabled related procedures to be analyzed together while avoiding duplicated counts and ensuring accurate trends over time.
While Medicaid expenditures climbed in many service areas, Radiology Procedures ranked as the fifth-highest category by total Medicaid payments in Summersville in 2024.
Statewide, Radiology Procedures ranked ninth overall for Medicaid payments in West Virginia for 2024.
Between 2019 and 2024, Medicaid payments for Radiology Procedures in Summersville rose by $1,001,109, or 81.7%. Spending grew more quickly during particular periods, with notable annual increases cited in 2020 and 2023.
Spending for Radiology Procedures was recorded across Summersville, with payments heavily concentrated in a few ZIP codes. In 2024, ZIP code 26651 accounted for $224,266 in Medicaid payments for this category, comprising 100% of all such payments in the city that year.
Most Medicaid payments within Radiology Procedures were associated with a small number of specific billing codes.
To compare, Medicaid payments for Radiology Procedures in Summersville rose 2.5% between 2024 and 2023, whereas overall Medicaid claim categories in the city saw an 11.9% change during the same timeframe.
Data from the Centers for Medicare & Medicaid Services indicates that combined federal and state Medicaid expenditures totaled approximately $871.7 billion in fiscal year 2023, which equaled nearly 18% of total U.S. health spending and marked an increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This change reflects growth of about 40% over several years, mostly attributed to higher enrollment and increased service use during and after the pandemic.
Recent federal budget measures under the Trump administration introduced major plans to scale back federal Medicaid funding and change the program’s structure. As an example, the One Big Beautiful Bill Act, enacted in 2025, is anticipated to reduce federal Medicaid spending by more than $1 trillion over the next decade. It establishes additional policies, including work requirements and expanded cost-sharing that could impact coverage and funding for certain beneficiaries, potentially shifting greater costs to the states and slowing the increase in federal support, despite the program’s continued coverage of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,225,375 | 156.3% |
| 2021 | $906,351 | -26% |
| 2022 | $215,777 | -76.2% |
| 2023 | $218,820 | 1.4% |
| 2024 | $224,266 | 2.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $2,907,398 | 45.3% |
| 2 | Evaluation and Management | $1,890,612 | 29.4% |
| 3 | Medicine Services and Procedures | $464,774 | 7.2% |
| 4 | Pathology and Laboratory Procedures | $463,620 | 7.2% |
| 5 | Radiology Procedures | $224,266 | 3.5% |
| 6 | Medical And Surgical Supplies | $166,296 | 2.6% |
| 7 | Durable Medical Equipment | $147,584 | 2.3% |
| 8 | Procedures / Professional Services | $57,736 | 0.9% |
| 9 | Dental Services | $39,947 | 0.6% |
| 10 | Surgery | $33,546 | 0.5% |
| 11 | Vision Services | $19,312 | 0.3% |
| 12 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $5,131 | 0.1% |
| 13 | Drugs Administered Other than Oral Method | $2,691 | <0.1% |
| 14 | Temporary Codes | $960 | <0.1% |
| 15 | Ambulance and Other Transport Services and Supplies | $291 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 74177 | Ct abd & pelvis w/contrast | $65,226 | 12 |
| 70450 | Ct head/brain w/o dye | $42,993 | 12 |
| 74176 | Ct abd & pelvis w/o contrast | $40,458 | 10 |
| 71045 | X-ray exam chest 1 view | $21,786 | 18 |
| 71250 | Ct thorax dx c- | $10,432 | 4 |
| 71046 | X-ray exam chest 2 views | $10,395 | 11 |
| 71275 | Ct angiography chest | $8,276 | 2 |
| 73030 | X-ray exam of shoulder | $5,051 | 10 |
| 73564 | X-ray exam knee 4 or more | $4,980 | 7 |
| 72125 | Ct neck spine w/o dye | $4,237 | 2 |
| 77067 | Scr mammo bi incl cad | $2,879 | 2 |
| 73562 | X-ray exam of knee 3 | $1,584 | 2 |
| 73630 | X-ray exam of foot | $1,434 | 3 |
| 77063 | Breast tomosynthesis bi | $1,195 | 2 |
| 72110 | X-ray exam l-2 spine 4/>vws | $1,021 | 1 |
| 73110 | X-ray exam of wrist | $717 | 1 |
| 73610 | X-ray exam of ankle | $677 | 1 |
| 73590 | X-ray exam of lower leg | $495 | 1 |
| 73502 | X-ray exam hip uni 2-3 views | $422 | 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.
