Medicaid payments for procedures and professional services in Mifflintown surge to $13,081 in 2024

In 2024, Medicaid providers in Mifflintown billed $13,081 for services under the Procedures / Professional Services category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That amount reflects a 3616.2% jump compared with 2023, when $352 in claims were filed for this service category.

Medicaid, a public health insurance initiative operated by states and funded by both federal and state governments, provides coverage for low-income individuals and families, as well as seniors, children, and people with disabilities. It represents one of the country’s key health care programs.

As Medicaid is funded by taxpayers, shifts in the amount billed locally can indicate changes in how the community utilizes public health funds.

The “Procedures / Professional Services” category covers a set of Medicaid-billed services identified by specific care types, based on standardized HCPCS and CPT code groupings. For analytical purposes, billing codes were sorted into a single service group using consistent prefixes and number ranges. This enabled examination of related services together, preventing double counting and sustaining accurate rankings year to year.

Procedures / Professional Services was the third-largest Medicaid payment category in Mifflintown for 2024, amid rising spending in a range of service categories.

Statewide, Procedures / Professional Services represented the fifth-highest Medicaid payment category in Pennsylvania in 2024.

Analyzing the five years through 2024, Medicaid payments to Procedures / Professional Services in Mifflintown rose by $13,081, or 0%. The rate of spending picked up in some years, with especially sharp increases in 2023 and 2022.

While funding for care in this category was spread through Mifflintown, payments were primarily concentrated within a select group of ZIP codes. In 2024, ZIP code 17059 accumulated $13,081 in Medicaid payments in this category, accounting for 100% of the Mifflintown total.

Within the Procedures / Professional Services category, a small set of individual billing codes represented the largest share of Medicaid payments.

Compared to the 3616.2% increase in Medicaid payments for the Procedures / Professional Services category from 2023 to 2024 in Mifflintown, all Medicaid claim categories in the city saw a combined growth of 13.5% during that period.

Centers for Medicare & Medicaid Services data show that federal and state Medicaid spending totaled about $871.7 billion in fiscal year 2023. This figure represents approximately 18% of total U.S. health expenditures, up significantly from $613.5 billion in 2019, prior to the COVID-19 pandemic.

That increase amounts to about 40% growth in a few years, mainly attributed to expanded Medicaid enrollment and a jump in utilization during and after the pandemic.

Congressional spending legislation during the Trump administration brought forward major proposals to scale back federal Medicaid contributions and restructure the program. The “One Big Beautiful Bill Act,” enacted in 2025, for example, is on track to cut over $1 trillion from federal Medicaid outlays over ten years. It adds work requirements and more cost-sharing responsibilities, which may trim beneficiary coverage and state funding. These changes are expected to move additional costs to states and slow the expansion of federal Medicaid assistance, while the program still supports millions of Americans nationwide.

Note: HCPCS codes are presented for context. Article totals and rankings are established using standardized service groupings instead of individual billing codes.

The U.S. Department of Health and Human Services Medicaid Provider Spending database was the source for information in this article. Access the original dataset here.