Montoursville Medicaid payments for Medicine Services and Procedures climb 36% in 2024

In 2024, medical providers in Montoursville billed $77,349 for services categorized as Medicine Services and Procedures through Medicaid, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That represents a 35.6% uptick compared with 2023, when claims for the same services totaled $57,030.

Medicaid, a public health insurance program operated by individual states with joint federal and state funding, covers low-income individuals and families, seniors, children, and those with disabilities. It is among the largest components of the U.S. health care system, supported by both federal and state governments.

Because taxpayers fund Medicaid, variation in local billing provides a window into how public health funds get spent within a community.

The “Medicine Services and Procedures” grouping applies to specific Medicaid-billed services outlined through standardized HCPCS and CPT coding systems. Each billing code was tied to one service group using established code prefixes and ranges for this analysis, which ensures that related services are collectively evaluated, avoids repeat counting, and maintains comparable trends over time.

Medicine Services and Procedures ranked as the No. 2 category in total Medicaid payments in Montoursville for 2024, even though Medicaid costs were up in multiple service categories.

Statewide across Pennsylvania, Medicine Services and Procedures held the No. 3 spot by total Medicaid payment amount in 2024.

In the five years through 2024, Montoursville’s Medicaid payments for the Medicine Services and Procedures group rose by $7,836, equating to a 9.2% increase. Spending notably accelerated in various years, with particularly strong annual jumps observed in 2020 and 2021.

Spending within this services category occurred throughout Montoursville, but much of it remained concentrated in just a few ZIP codes. In 2024, ZIP code 17754 alone accounted for $77,348 in Medicaid payments for Medicine Services and Procedures. This leading ZIP code comprised 100% of local Medicaid payments in this services category that year.

Payments from the Medicine Services and Procedures group largely focused on just a handful of individual billing codes.

When compared to all Medicaid categories in Montoursville, Medicine Services and Procedures payments jumped 35.6% from 2023 to 2024, while combined Medicaid claim categories saw a 12.9% change during that period.

According to the Centers for Medicare & Medicaid Services, overall Medicaid spending by federal and state governments reached approximately $871.7 billion for fiscal 2023. This figure made up about 18% of total national health expenditures and represents a sharp rise from $613.5 billion in 2019, before the start of the COVID-19 pandemic.

This increase, driven largely by expanding enrollment and increased utilization through and after the pandemic, amounts to about 40% in just a few years.

Recent federal budget legislation passed under the Trump administration put forward significant moves to reduce federal Medicaid funding and reshape the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid spending by more than $1 trillion over the next 10 years, introducing policies such as work requirements and increased cost-sharing. These measures may shrink Medicaid coverage and funding for certain groups. As a result, states are anticipated to shoulder more of the costs, limiting the federal growth in Medicaid’s support even as the program continues to serve millions nationwide.

Note: HCPCS codes are presented for context within the category. Totals and rankings in this report reference service category groupings, not individual billing codes.

The information in this piece is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database, with the underlying data available here.