Medicaid providers in Weston billed $161,940 for services included in the Procedures / Professional Services category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 5.1% rise from the prior year, when $154,046 in claims were made for these services.
Medicaid is a public insurance program administered by states and funded jointly by federal and state governments. Designed to assist low-income individuals and families, seniors, children and people with disabilities, it is among the largest health programs in the U.S.
Because taxpayer dollars fund Medicaid, fluctuations in local billing indicate how public health resources are directed within a community.
The “Procedures / Professional Services” group refers to a set of Medicaid-billed services defined by care type, utilizing standardized HCPCS and CPT code clusters. For this analysis, each billing code was assigned one service category based on organizing code prefixes and numeric slots, allowing for grouped analysis, eliminating duplicate counts and supporting consistent ranking through time.
Though overall Medicaid spending increased in several categories, Procedures / Professional Services held the fifth ranking by total Medicaid payments for Weston in 2024.
At the state level, Procedures / Professional Services was the eighth-largest Medicaid payment category in West Virginia for 2024.
Between 2019 and 2024, Medicaid payments for the Procedures / Professional Services category in Weston grew by $2,336, or 1.4%. Certain years saw faster spending growth, including notable rises in 2022 and 2023.
While spending for Procedures / Professional Services was distributed throughout Weston, most payments were focused in a small number of ZIP codes. In 2024, ZIP code 26452 accounted for $161,940 in Medicaid payments for this category. In total, the top ZIP code represented 100% of payments tied to these services in Weston that year.
Payments were also concentrated among a relatively small set of individual billing codes within the Procedures / Professional Services group.
Comparatively, the 5.1% year-over-year increase for Procedures / Professional Services matched the overall increase across all Medicaid claim categories locally during the same period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures reached about $871.7 billion in fiscal year 2023. This made up nearly 18% of national health costs, up significantly from roughly $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This rise amounts to approximately 40% growth in a few years, with expanded enrollment and greater health service use during and after the pandemic as primary drivers.
Recent federal spending measures from the Trump administration have included major proposals to lower federal Medicaid contributions and revise coverage. For instance, the “One Big Beautiful Bill Act,” passed in 2025, is forecast to cut more than $1 trillion in federal Medicaid funding over the next 10 years. It also introduces policies such as work requirements and higher cost-sharing, which could reduce both coverage and funding for certain groups. As a result, these adjustments are likely to impose more costs on states and restrict federal Medicaid funding growth, though the program continues to serve tens of millions of people nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $164,275 | -9.3% |
| 2021 | $125,962 | -23.3% |
| 2022 | $125,027 | -0.7% |
| 2023 | $154,045 | 23.2% |
| 2024 | $161,940 | 5.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $2,345,605 | 57.1% |
| 2 | Evaluation and Management | $622,820 | 15.2% |
| 3 | Temporary National Codes (Non-Medicare) | $339,988 | 8.3% |
| 4 | Ambulance and Other Transport Services and Supplies | $324,837 | 7.9% |
| 5 | Procedures / Professional Services | $161,940 | 3.9% |
| 6 | Medicine Services and Procedures | $121,256 | 2.9% |
| 7 | Durable Medical Equipment | $78,690 | 1.9% |
| 8 | Pathology and Laboratory Procedures | $75,938 | 1.8% |
| 9 | Radiology Procedures | $17,778 | 0.4% |
| 10 | Surgery | $8,697 | 0.2% |
| 11 | Medical And Surgical Supplies | $6,545 | 0.2% |
| 12 | Drugs Administered Other than Oral Method | $3,593 | 0.1% |
| 13 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $2,293 | 0.1% |
| 14 | Temporary Codes | $659 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G9002 | Mccd,maintenance rate | $151,823 | 11 |
| G0463 | Hospital outpt clinic visit | $7,066 | 11 |
| G0378 | Hospital observation per hr | $2,766 | 4 |
| G2211 | Complex e/m visit add on | $283 | 9 |
| G1004 | Cdsm ndsc | $0 | 27 |
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.
