In 2024, Medicaid providers in Metuchen submitted $234,881 in claims for the Medicine Services and Procedures category, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 150.6% increase compared with 2023, when providers filed $93,743 in claims for this category.
Medicaid, a public health insurance initiative managed by states and funded jointly by federal and state governments, offers coverage for low-income individuals and families, seniors, children, and people with disabilities. It remains one of the largest components of the U.S. health care system.
As Medicaid payments are funded by taxpayers, shifts in local billing illustrate community allocation of public health care dollars.
The “Medicine Services and Procedures” category includes a set of Medicaid-billed services identified by the nature of care through standardized HCPCS and CPT code groupings. For this report, each billing code was assigned to a single service group using consistent code prefixes and numeric ranges. This approach ensures related services are grouped together for analysis without double counting, allowing accurate trend comparisons over time.
Spending on Medicaid services increased across multiple categories; in 2024, Medicine Services and Procedures ranked fourth in total Medicaid payments in Metuchen.
Statewide in New Jersey, this category also held the fourth spot for Medicaid payments in 2024.
In the five years preceding 2024, Medicaid payments connected to the Medicine Services and Procedures category in Metuchen grew by $144,312, or 159.3%. The data indicates periods of rapid growth, with significant annual increases observed in 2023 and 2021.
Payments for Medicine Services and Procedures spanned the city but were concentrated in just a few ZIP codes. In 2024, ZIP code 08840 accounted for $234,880, representing 100% of all Medicaid payments tied to this category in Metuchen for the year.
Within this category, Medicaid reimbursements focused heavily on a relatively small number of individual billing codes.
For perspective, the 150.6% year-over-year rise for this category in Metuchen between 2024 and 2023 compared with a 10.3% overall increase across all Medicaid claim types locally over the same period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending together reached about $871.7 billion in fiscal year 2023, equal to roughly 18% of all national health expenditures—an increase from about $613.5 billion in 2019, prior to the COVID-19 public health emergency.
This increase represents about 40% growth in just a few years, largely fueled by expanded Medicaid enrollment and increased utilization during and following the pandemic period.
Recent federal budget actions under the Trump administration included significant proposals to reduce federal Medicaid spending and alter the program’s structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is set to cut more than $1 trillion in federal Medicaid outlays over the next decade and introduces features like work requirements and greater cost-sharing that may impact coverage for some recipients. These changes are expected to shift more of the Medicaid funding burden onto states and limit federal growth, even as the program continues to serve tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $90,568 | -44% |
| 2021 | $95,169 | 5.1% |
| 2022 | $79,289 | -16.7% |
| 2023 | $93,743 | 18.2% |
| 2024 | $234,880 | 150.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $10,348,249 | 80.3% |
| 2 | Evaluation and Management | $1,703,224 | 13.2% |
| 3 | Temporary National Codes (Non-Medicare) | $471,799 | 3.7% |
| 4 | Medicine Services and Procedures | $234,880 | 1.8% |
| 5 | Surgery | $43,107 | 0.3% |
| 6 | Pathology and Laboratory Procedures | $27,215 | 0.2% |
| 7 | Anesthesia | $20,507 | 0.2% |
| 8 | Radiology Procedures | $17,422 | 0.1% |
| 9 | Administrative, Miscellaneous and Investigational | $7,912 | 0.1% |
| 10 | Diagnostic Radiology Services | $3,310 | <0.1% |
| 11 | Drugs Administered Other than Oral Method | $1,833 | <0.1% |
| 12 | Temporary Codes | $1,003 | <0.1% |
| 13 | Procedures / Professional Services | $19 | <0.1% |
| 14 | Dental Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90999 | Unlisted dialysis procedure | $126,941 | 6 |
| 93306 | Tte w/doppler complete | $45,874 | 11 |
| 92507 | Tx sp lang voice comm indiv | $34,114 | 4 |
| 93015 | Cv stress test supvj i&r | $15,447 | 11 |
| 97803 | Med nutrition indiv subseq | $5,467 | 4 |
| 93000 | Electrocardiogram complete | $5,330 | 11 |
| 91200 | Liver elastography | $1,178 | 10 |
| 97110 | Therapeutic exercises | $277 | 10 |
| 94640 | Airway inhalation treatment | $130 | 2 |
| 97140 | Manual therapy 1/> regions | $90 | 10 |
| 90662 | Iiv no prsv increased ag im | $27 | 1 |
| 93923 | Upr/lxtr art stdy 3+ lvls | $0 | 1 |
| 97813 | Acup 1/> w/estim 1st 15 min | $0 | 3 |
| 97814 | Acup 1/> w/estim ea addl 15 | $0 | 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.
