Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows North Carolina Medicaid payments totaled $5,509,330 for services categorized under Vision Services in 2024. This figure reflects a 1.9% rise from 2023, when providers billed $5,406,554 for these services.
Medicaid, jointly funded by federal and state governments and administered by the states, is a public health insurance program covering low-income individuals and families, seniors, children, and people with disabilities. It remains one of the country’s largest health care programs.
Because Medicaid expenditures are funded by taxpayers, variations in local billing indicate how public health dollars are distributed within communities.
The Vision Services category includes a defined set of Medicaid-billed services based on standardized HCPCS and CPT code clusters. For this report, each billing code was matched to a unique service category using uniform code prefixes and numerical groupings, which enables tracking of related services while avoiding duplicate counts and maintaining ranking integrity over time.
When relevant, service categories may encompass several types of services, grouping forms of care commonly billed together under Medicaid, such as office visits, diagnostic exams, and therapeutic treatments.
In the five years before 2024, Medicaid payments for the Vision Services category in North Carolina rose by $1,120,843, or 25.5%. Growth in spending accelerated during particular intervals, including notable annual jumps in 2021 and 2023.
Spending for Vision Services was distributed statewide but concentrated in just a few ZIP codes. For 2024, the ZIP codes recording the highest Medicaid payments for Vision Services were 27856, with $5,494,546 (99.7% of the total), 28144 at $4,683 (0.1%), and 27889, which saw $2,953 (0.1%).
Combined, the leading three ZIP codes represented 99.9% of all Medicaid payments for Vision Services in the state that year.
Looking more broadly, total Medicaid payments statewide across all claim categories went up 3.2% from 2023 to 2024.
Across the various types of services with increased Medicaid payments, Vision Services ranked among the top 17 service categories in North Carolina by total payments in 2024.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid outlays were about $871.7 billion in fiscal year 2023, making up roughly 18% of national health expenditures and marking a sharp uptick from $613.5 billion in 2019 prior to the COVID-19 pandemic.
This substantial increase of roughly 40% over several years reflects expanded enrollment and bigger service use during and after the pandemic.
Recent federal budget actions under the Trump administration have set forth significant plans to reduce federal Medicaid outlays and change the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to trim more than $1 trillion from federal Medicaid spending over 10 years and imposes new requirements such as work mandates and greater cost-sharing, which may decrease coverage and funding for certain enrollees. These measures are likely to shift more costs to states and slow federal Medicaid growth, even as millions of Americans continue to rely on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2024 | $5,509,330 | 1.9% |
| 2023 | $5,406,554 | 7.8% |
| 2022 | $5,014,823 | -2.6% |
| 2021 | $5,149,471 | 17.3% |
| 2020 | $4,388,487 | -22.3% |
| 2019 | $5,645,541 | 44.9% |
| 2018 | $3,896,951 | N/A |
| ZIP Code | Medicaid Payments | % of State Total |
|---|---|---|
| 27856 | $5,494,546 | 99.7% |
| 28144 | $4,683 | 0.1% |
| 27889 | $2,953 | 0.1% |
| 28301 | $2,631 | <0.1% |
| 28217 | $1,694 | <0.1% |
| 27565 | $1,090 | <0.1% |
| 27215 | $561 | <0.1% |
| 28546 | $429 | <0.1% |
| 27870 | $274 | <0.1% |
| 28387 | $142 | <0.1% |
| 27607 | $123 | <0.1% |
| 28211 | $112 | <0.1% |
| 27408 | $55 | <0.1% |
| 28210 | $37 | <0.1% |
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.