In 2024, Medicaid providers in Jersey Shore billed a total of $9,745 for services within the Procedures / Professional Services category, as reported by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented an increase of 316.5% over 2023, when providers submitted $2,340 in claims for this service category.
Medicaid is a public insurance program coordinated by states and funded by both federal and state governments. It provides health coverage for low-income populations, including families, seniors, children and people with disabilities, and ranks among the largest components of U.S. health care spending.
Since Medicaid funding is sourced from taxpayers, shifts in billing at the local level highlight how health care dollars are directed within the community.
The Procedures / Professional Services category includes a variety of Medicaid-billed services, identified by specific HCPCS and CPT codes. For the purposes of this analysis, each billing code was grouped into a single service category based on rules using code prefixes and number ranges, which enabled the analysis of correlated services without double-counting and allowed consistent tracking over years.
Among different service categories with rising Medicaid spending, Procedures / Professional Services placed sixth in Jersey Shore by total payments during 2024.
Statewide in Pennsylvania, the Procedures / Professional Services group held the fifth position for Medicaid payment totals in 2024.
Between 2019 and 2024, Medicaid claims related to Procedures / Professional Services in Jersey Shore grew by $9,745, equating to 0% overall change. Certain periods drove higher growth, especially with pronounced annual increases observed in both 2023 and 2022.
Spending for services classified within Procedures / Professional Services was dispersed throughout Jersey Shore but tended to cluster in a small number of ZIP codes. In 2024, the highest payments for this category were reported in ZIP code 17740, which made up $9,745 of the total. The top ZIP code was responsible for 100% of Medicaid payments related to Procedures / Professional Services in the city for that year.
Payments in the Procedures / Professional Services group were concentrated around a relatively small subset of billing codes.
To compare, Medicaid payments linked to Procedures / Professional Services increased 316.5% for Jersey Shore between 2024 and 2023, while all Medicaid categories in the city combined posted a 7.1% change during the corresponding time span.
According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid expenditures totaled about $871.7 billion for fiscal year 2023, making up approximately 18% of overall national health costs, and up significantly from around $613.5 billion in 2019, prior to the COVID-19 public health emergency.
This marks an expansion of roughly 40% in just a few years, fueled primarily by enrollment growth and increased service usage since the pandemic period began.
Congressional budget measures adopted during the Trump administration proposed sharp decreases to federal Medicaid funding and significant changes to program design. The “One Big Beautiful Bill Act,” signed in 2025, is expected to reduce federal Medicaid outlays by more than $1 trillion over 10 years, introducing work mandates and higher cost-sharing, which could restrict spending and program access for some enrollees. These developments are projected to shift additional costs to states and restrict federal Medicaid expansion, while the program continues covering many millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2023 | $2,339 | – |
| 2024 | $9,745 | 316.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $405,921 | 64.8% |
| 2 | National Codes Established for State Medicaid Agencies | $136,801 | 21.8% |
| 3 | Pathology and Laboratory Procedures | $32,851 | 5.2% |
| 4 | Ambulance and Other Transport Services and Supplies | $22,352 | 3.6% |
| 5 | Medicine Services and Procedures | $17,357 | 2.8% |
| 6 | Procedures / Professional Services | $9,745 | 1.6% |
| 7 | Radiology Procedures | $1,601 | 0.3% |
| 8 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 8 | Dental Services | $0 | <0.1% |
| 8 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| 8 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G2211 | Complex e/m visit add on | $9,213 | 18 |
| G0008 | Admin influenza virus vac | $532 | 3 |
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.
