In 2024, Medicaid providers in Clayton billed $5,536,939 for services in the Medicine Services and Procedures category, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects a 1.1% rise from 2023, when $5,479,149 was claimed for the same category.
Medicaid is a publicly funded health insurance program operated at the state level and supported by both federal and state governments. The program provides health coverage for low-income families and individuals, seniors, children, and those with disabilities, making it a significant component of the U.S. health care infrastructure.
Changing taxpayer-funded Medicaid payment levels locally can demonstrate how public funds are being used in the health care sector of a community.
The “Medicine Services and Procedures” category consists of Medicaid-billed care identified by standardized HCPCS and CPT codes. For this report, billing codes were grouped into a single category based on code prefixes and numeric ranges to enable accurate evaluation while preventing duplicate counting and maintaining accurate category rankings over time.
While overall Medicaid payments increased among various categories, Medicine Services and Procedures received the highest Medicaid payouts among service categories in Clayton for 2024.
Statewide in North Carolina, the Medicine Services and Procedures category was the third-largest by Medicaid payments in 2024.
From five years prior to 2024, Medicaid Medicine Services and Procedures payments in Clayton increased by $1,746,251, representing 46.1% growth. Certain years, such as 2021 and 2023, saw particularly strong year-over-year increases.
Medicaid payments for the Medicine Services and Procedures category were not evenly spread throughout all of Clayton; instead, the highest amounts were found within specific ZIP codes. In 2024, ZIP code 27520 accounted for $4,364,824 and ZIP code 27527 reported $1,172,114. Together, these two ZIP codes made up 100% of Medicaid payments in Clayton tied to this service category in 2024.
A small selection of individual billing codes accounted for most Medicaid payments within the Medicine Services and Procedures category.
Comparatively, Medicaid payments for Medicine Services and Procedures in Clayton increased by 1.1% between 2024 and 2023, while total payments across all Medicaid claim categories in the city saw a 9.4% change for the same timeframe.
The Centers for Medicare & Medicaid Services reports a combined federal and state Medicaid spending of about $871.7 billion in fiscal 2023, equivalent to roughly 18% of nationwide health expenditures, which grew from approximately $613.5 billion in 2019 before the onset of COVID-19.
This growth amounts to around 40% in a few years, mainly due to increased enrollment and greater utilization in the period surrounding the pandemic.
Recent federal budget changes introduced by the Trump administration have included proposals to curb federal Medicaid proportions and reorganize the program. The “One Big Beautiful Bill Act,” passed in 2025, is expected to cut more than $1 trillion in federal Medicaid spending through the coming decade and includes new policies on work qualifications and higher cost-sharing. These measures may cut coverage and funding for some recipients and shift more spending responsibility to states, potentially limiting further federal expansion even as Medicaid remains vital for millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $3,790,687 | 0.1% |
| 2021 | $4,924,343 | 29.9% |
| 2022 | $4,339,058 | -11.9% |
| 2023 | $5,479,149 | 26.3% |
| 2024 | $5,536,939 | 1.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $5,536,939 | 46.3% |
| 2 | Alcohol and Drug Abuse Treatment | $4,031,980 | 33.7% |
| 3 | Evaluation and Management | $1,964,104 | 16.4% |
| 4 | Dental Services | $282,937 | 2.4% |
| 5 | Durable Medical Equipment | $58,451 | 0.5% |
| 6 | Temporary National Codes (Non-Medicare) | $42,007 | 0.4% |
| 7 | Pathology and Laboratory Procedures | $23,277 | 0.2% |
| 8 | Medical And Surgical Supplies | $19,566 | 0.2% |
| 9 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $3,112 | <0.1% |
| 10 | Surgery | $2,624 | <0.1% |
| 11 | Radiology Procedures | $274 | <0.1% |
| 12 | Procedures / Professional Services | $16 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 92507 | Tx sp lang voice comm indiv | $2,384,693 | 313 |
| 99509 | Home visit day life activity | $1,293,313 | 24 |
| 97153 | Adaptive behavior tx by tech | $790,755 | 12 |
| 97530 | Therapeutic activities | $522,396 | 58 |
| 97155 | Adapt behavior tx phys/qhp | $228,353 | 19 |
| 90999 | Unlisted dialysis procedure | $70,238 | 10 |
| 90837 | Psytx w pt 60 minutes | $66,212 | 14 |
| 90471 | Immunization admin | $33,735 | 67 |
| 97156 | Fam adapt bhv tx gdn phy/qhp | $33,637 | 16 |
| 90472 | Immunization admin each add | $32,223 | 40 |
| 92523 | Speech sound lang comprehen | $27,221 | 11 |
| 96110 | Developmental screen w/score | $15,637 | 50 |
| 92340 | Fit spectacles monofocal | $9,045 | 21 |
| 92370 | Rpr&refitg spect xcp aphakia | $4,282 | 21 |
| 94060 | Evaluation of wheezing | $3,230 | 8 |
| 90791 | Psych diagnostic evaluation | $3,205 | 2 |
| 96127 | Brief emotional/behav assmt | $2,651 | 27 |
| 94664 | Demo&/eval pt use inhaler | $2,237 | 8 |
| 92551 | Pure tone hearing test air | $2,057 | 38 |
| 94618 | Pulmonary stress testing | $1,962 | 8 |
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.
