Medicaid procedures, professional services payments up 1.9% in Garwood for 2024

Garwood Medicaid providers billed $4,522 in 2024 for services under the Procedures / Professional Services category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This was a rise of 1.9% from 2023, when submissions totaled $4,436 for the same category.

Medicaid is a public health insurance program managed by states and financed in partnership by federal and state governments. It serves low-income populations including individuals, families, seniors, children, and people with disabilities, making it a major component of the U.S. health care system.

Since Medicaid payments are taxpayer funded, local billing amounts help illustrate the distribution of public health dollars within a community.

The “Procedures / Professional Services” category groups Medicaid-billed services according to care type, based on HCPCS and CPT coding conventions. For this reporting, each billing code was placed in a single service category by aligning code prefixes and range guidelines, ensuring services remained grouped by type, without duplication, and allowing for year-over-year comparisons.

Although overall Medicaid spending rose in several categories, Procedures / Professional Services represented the sixth-largest Medicaid payment category by total value in Garwood during 2024.

Statewide in New Jersey, Procedures / Professional Services ranked as the seventh-largest Medicaid payment category for 2024.

From 2020 through 2024, Garwood Medicaid payments for Procedures / Professional Services climbed by $10,716, or 70.3%. The rate of growth picked up at certain points, especially in the years 2022 and 2023, which both showed significant annual increases.

Although Procedures / Professional Services payments were made throughout Garwood, most of these funds were concentrated in specific ZIP codes. For 2024, ZIP code 07027 saw $4,522 in Medicaid payments linked to Procedures / Professional Services, making up 100% of Garwood’s payments for that category that year.

Spending within this service category also tended to be concentrated among a small number of billing codes.

Comparatively, the 1.9% payment increase for Procedures / Professional Services from 2023 to 2024 contrasted with a 17.2% change across all Medicaid claim categories in Garwood for the same period.

The Centers for Medicare & Medicaid Services report that combined state and federal Medicaid spending reached approximately $871.7 billion in fiscal 2023, or about 18% of total U.S. health expenditures. That was a sharp rise from roughly $613.5 billion in 2019, before the COVID-19 pandemic.

This reflects an increase of about 40% within several years, largely attributable to greater enrollment and heightened utilization during and following the pandemic.

New federal budget measures during Donald Trump’s presidency have included proposals targeting federal Medicaid reductions and adjustments in program design. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid spending by over $1 trillion in the next decade, bringing in policies like work requirements and increased cost responsibilities that may decrease certain beneficiaries’ coverage and funding. These adjustments are forecasted to transfer additional costs to states and rein in the growth of federal support while the program remains a critical resource to millions of Americans.

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.