According to the U.S. Department of Health and Human Services Medicaid Provider Spending database, Lewistown Medicaid providers billed $325,212 for Pathology and Laboratory Procedures in 2024. This figure reflects a 1.4% rise from 2023, when claims for the same services amounted to $320,764.
Medicaid, a public health insurance program managed at the state level with joint federal and state funding , offers coverage to low-income individuals and families, seniors, children, and people with disabilities. It is a key component of the U.S. health care landscape.
Because taxpayer dollars fund Medicaid payments, shifts in local billing indicate how public health care resources are allocated within communities.
The “Pathology and Laboratory Procedures” category includes services grouped by type of care, assigned by standardized HCPCS and CPT code prefixes and numeric ranges. This approach groups similar services together for analysis, preventing double counting while ensuring accurate tracking and rankings over time.
Although Lewistown saw overall growth across service categories, Pathology and Laboratory Procedures placed sixth by total Medicaid payments in 2024.
Statewide in Pennsylvania, Pathology and Laboratory Procedures ranked ninth by total payments in 2024.
Throughout the five years prior to 2024, Medicaid disbursements for Pathology and Laboratory Procedures in Lewistown increased by $174,918, or 116.4%. Growth rates accelerated during select years, particularly in 2020 and 2021.
Spending within Lewistown for Pathology and Laboratory Procedures mainly originated in a limited set of ZIP codes. In 2024, ZIP code 17044 accounted for nearly all Medicaid payments in this category, with $325,211. As a result, the leading ZIP code comprised 100% of local spending on Pathology and Laboratory Procedures.
Payments in the Pathology and Laboratory Procedures category were notably concentrated on a small set of billing codes.
To put the local trend into perspective, Pathology and Laboratory Procedures-related Medicaid claims in Lewistown increased by 1.4% from 2023 to 2024, whereas the sum of all Medicaid claim categories in the city rose by 9.1% in that span.
According to the Centers for Medicare & Medicaid Services, Medicaid’s total federal and state spending reached approximately $871.7 billion for fiscal year 2023, making up nearly 18% of national health expenditures—an increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This change amounts to nearly 40% spending growth in only a few years, due in part to rising enrollment and higher service utilization during and following the pandemic.
Recently enacted federal budget laws under the Trump administration have included large-scale proposals to decrease federal Medicaid contributions and alter its structure. The “One Big Beautiful Bill Act,” signed in 2025, is expected to cut more than $1 trillion in federal Medicaid support over the next 10 years while introducing policies such as work requirements and greater cost-sharing responsibilities. These changes may shift additional costs to the states and potentially slow federal funding growth, even as Medicaid continues to insure tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $150,294 | 26858.2% |
| 2021 | $824,578 | 448.6% |
| 2022 | $289,742 | -64.9% |
| 2023 | $320,763 | 10.7% |
| 2024 | $325,211 | 1.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $1,750,566 | 27.3% |
| 2 | Alcohol and Drug Abuse Treatment | $1,497,625 | 23.3% |
| 3 | National Codes Established for State Medicaid Agencies | $1,204,274 | 18.8% |
| 4 | Medicine Services and Procedures | $703,824 | 11% |
| 5 | Ambulance and Other Transport Services and Supplies | $667,475 | 10.4% |
| 6 | Pathology and Laboratory Procedures | $325,211 | 5.1% |
| 7 | Procedures / Professional Services | $81,039 | 1.3% |
| 8 | Durable Medical Equipment | $75,055 | 1.2% |
| 9 | Radiology Procedures | $65,853 | 1% |
| 10 | Surgery | $20,305 | 0.3% |
| 11 | Medical And Surgical Supplies | $19,245 | 0.3% |
| 12 | Vision Services | $3,742 | 0.1% |
| 13 | Dental Services | $1,456 | <0.1% |
| 14 | Temporary Codes | $10 | <0.1% |
| 15 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 15 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 80053 | Comprehen metabolic panel | $65,552 | 169 |
| 80307 | Drug test prsmv chem anlyzr | $43,366 | 28 |
| 85025 | Complete cbc w/auto diff wbc | $33,292 | 166 |
| 84443 | Assay thyroid stim hormone | $15,853 | 22 |
| 84484 | Assay of troponin quant | $15,656 | 78 |
| 84702 | Chorionic gonadotropin test | $14,226 | 53 |
| 87631 | Resp virus 3-5 targets | $11,895 | 4 |
| 80061 | Lipid panel | $11,233 | 24 |
| 87637 | Sarscov2&inf a&b&rsv amp prb | $10,780 | 6 |
| 87491 | Chlmyd trach dna amp probe | $10,072 | 20 |
| 87591 | N.gonorrhoeae dna amp prob | $7,852 | 17 |
| 87481 | Candida dna amp probe | $7,741 | 10 |
| 83690 | Assay of lipase | $7,602 | 77 |
| 87086 | Urine culture/colony count | $6,280 | 46 |
| 82306 | Vitamin d 25 hydroxy | $6,147 | 9 |
| 83605 | Assay of lactic acid | $5,851 | 50 |
| 87661 | Trichomonas vaginalis amplif | $5,405 | 9 |
| 83036 | Hemoglobin glycosylated a1c | $4,672 | 21 |
| 81001 | Urinalysis auto w/scope | $4,400 | 78 |
| 82607 | Vitamin b-12 | $3,686 | 11 |
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.
