Procedures and professional services billed to Medicaid rise to $4,760 in Carteret for 2024

In 2024, Carteret Medicaid providers billed $4,760 for services grouped in the Procedures / Professional Services category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 6.4% increase compared with 2023, when providers billed $4,474 for the same category.

Medicaid, a public insurance program managed by states and funded by both the federal and state governments, serves low-income groups, seniors, children, and people with disabilities. It’s one of the main components of the U.S. health care system.

Since Medicaid expenditures are sourced from taxpayers, shifts in local billing amounts represent how public health care resources are allocated locally.

The “Procedures / Professional Services” category includes various Medicaid-billed services defined by the type of care, using standardized HCPCS and CPT code groupings. For this report, billing codes were sorted into single service categories based on code prefixes and numbers to ensure related services could be analyzed together, avoid double counting, and maintain accurate rankings over time.

Though Medicaid spending rose in several service categories, Procedures / Professional Services ranked fifth for total Medicaid payments in Carteret during 2024.

At the state level, Procedures / Professional Services was the seventh-largest category by Medicaid payment totals in New Jersey in 2024.

Between 2019 and 2024, Medicaid payments for Procedures / Professional Services in Carteret increased by $153, a 3.1% rise. Spending growth was faster in certain years, with significant increases posted in both 2020 and 2021.

Spending for Procedures / Professional Services was distributed throughout Carteret, but payments were primarily concentrated in just a handful of ZIP codes. In 2024, ZIP code 07008 reached $4,759 in Medicaid payments, representing 100% of Carteret’s total for this category that year.

Within this category, a small set of billing codes accounted for most Medicaid payments.

For comparison, Carteret’s Procedures / Professional Services Medicaid payments increased by 6.4% from 2023 to 2024, while all claim categories in the city experienced a 15.5% year-over-year change in that period.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid expenditures reached about $871.7 billion in fiscal year 2023—around 18% of the country’s overall health spending—up sharply from $613.5 billion in 2019, before the COVID-19 pandemic.

This growth amounts to about a 40% increase over several years, mainly due to expanded enrollment and higher service usage during the pandemic and the period following it.

Recent federal budget actions during the Trump administration introduced major proposals to reduce federal Medicaid funding and change the program’s structure. Notably, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to decrease federal Medicaid funding by over $1 trillion over the next 10 years, with new policies such as work requirements and increased cost-sharing that may limit coverage and funding for some recipients. These initiatives are likely to shift more financial responsibility to states and restrict further federal growth for the program even as enrollment numbers remain high.

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.