In 2024, Avenel Medicaid providers billed $414 for services under the Procedures / Professional Services category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a 253.8% rise compared to 2023, when claims for the same category totaled $117.
Medicaid, a state-administered public health insurance program financed jointly by federal and state governments, covers low-income residents, seniors, children, and people with disabilities, making it one of the largest parts of the nation’s health care system.
Because Medicaid relies on taxpayer funding, fluctuations in local billing reflect how public health resources are distributed in the community.
The Procedures / Professional Services category includes a range of services that are billed to Medicaid, grouped by the nature of care provided according to standardized HCPCS and CPT code ranges. For this review, each code was associated with a single service group based on prefix and code range criteria, enabling analysis of related services together and preventing duplicate counts to maintain ranking consistency over time.
While total Medicaid expenses increased in several categories, Procedures / Professional Services ranked eighth for total payments in Avenel during 2024.
At the statewide level, Procedures / Professional Services placed seventh among all categories for total Medicaid payments in New Jersey in 2024.
From the five years prior to 2024, Medicaid expenditures in Avenel for Procedures / Professional Services rose by $414, or 0%. Notably, spending growth surged in some years, especially between 2023 and 2022.
Although Procedures / Professional Services payments were made citywide, a substantial portion was concentrated in a few ZIP codes. For 2024, ZIP code 07001 accounted for $413 in such Medicaid payments, representing 99.9% of all category spending in Avenel for the year.
A small set of billing codes in the Procedures / Professional Services category accounted for most Medicaid payments.
To place this in context, Medicaid payments for Procedures / Professional Services in Avenel jumped 253.8% from 2023 to 2024, whereas overall Medicaid claim categories increased 27.2% in the city over the same period.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending reached approximately $871.7 billion in fiscal 2023, which was about 18% of all national health expenditures, rising significantly from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This increase represents nearly 40% growth in several years, fueled primarily by expanded program enrollment and higher utilization during and after the pandemic.
Recent federal legislation under the Trump administration introduced significant revisions to Medicaid funding and operational structure. The “One Big Beautiful Bill Act,” signed in 2025, is set to reduce federal Medicaid spending by more than $1 trillion over the coming decade and incorporates policies like work requirements and higher cost-sharing, which may limit coverage and shift further costs to the states even as the program continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2022 | $164 | – |
| 2023 | $117 | -28.6% |
| 2024 | $413 | 252.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $1,185,579 | 57.3% |
| 2 | Medicine Services and Procedures | $520,755 | 25.2% |
| 3 | National Codes Established for State Medicaid Agencies | $125,120 | 6% |
| 4 | Medical And Surgical Supplies | $82,517 | 4% |
| 5 | Orthotic Procedures and services | $70,860 | 3.4% |
| 6 | Ambulance and Other Transport Services and Supplies | $45,636 | 2.2% |
| 7 | Pathology and Laboratory Procedures | $39,265 | 1.9% |
| 8 | Procedures / Professional Services | $413 | <0.1% |
| 9 | Surgery | $273 | <0.1% |
| 10 | Drugs Administered Other than Oral Method | $67 | <0.1% |
| 11 | Dental Services | $0 | <0.1% |
| 11 | Temporary National Codes (Non-Medicare) | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0447 | Behavior counsel obesity 15m | $262 | 16 |
| G2211 | Complex e/m visit add on | $81 | 10 |
| G0008 | Admin influenza virus vac | $69 | 1 |
| G8417 | Calc bmi abv up param f/u | $0 | 3 |
| G8752 | Sys bp less 140 | $0 | 3 |
| G8754 | Dias bp less 90 | $0 | 4 |
Note: HCPCS codes are provided to illustrate services within the category. Rankings and category totals throughout this article are based on standardized service groupings and not individual billing codes.
The information in this report comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data is available here.
