In 2024, Medicaid providers in Point Pleasant submitted $3,829 in claims for services grouped under the Medicine Services and Procedures category, according to information from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 58.4% rise compared with 2023, when claims for the same category totaled $2,417.
Medicaid, which is administered by states and funded through both federal and state resources, covers low-income groups, seniors, children, and individuals with disabilities, making it a major component of the nation’s health care system.
As Medicaid funding is sourced from taxpayers, any local changes in claim levels directly impact how public health care resources are spent within the community.
The Medicine Services and Procedures category includes various Medicaid-billed services, grouped by type of care using HCPCS and CPT code sets. In this report, billing codes were assigned consistently to a single category by their code prefixes and ranges, supporting effective comparisons over time while preventing duplicated counts or misrankings.
Across multiple categories, Medicaid payments rose, but Medicine Services and Procedures ranked seventh in Point Pleasant for total Medicaid funds paid in 2024.
Statewide in West Virginia, Medicine Services and Procedures placed sixth in terms of Medicaid payment totals for 2024.
Between 2019 and 2024, Medicaid payments in Point Pleasant tied to Medicine Services and Procedures increased by $186,457, or 98%. Growth accelerated during certain years, with sizable gains seen year over year in 2023 and 2022.
Although Medicaid spending on Medicine Services and Procedures was found across Point Pleasant, the majority was concentrated in a small number of ZIP codes. In 2024, ZIP code 25550 accounted for the full $3,829 attributed to this category, representing 100% of such claims in the city for the year.
Most Medicaid payments for Medicine Services and Procedures in Point Pleasant were associated with a small selection of billing codes.
To compare, the 58.4% jump in Medicine Services and Procedures Medicaid payments from 2023 to 2024 outpaced the 14.4% increase seen across all Medicaid claim categories during the same period within the city.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached approximately $871.7 billion for fiscal year 2023, representing around 18% of all national health expenditures. This is a significant rise from about $613.5 billion in 2019, prior to the COVID-19 pandemic.
This reflects an increase of roughly 40% over just a few years, driven largely by a greater number of enrollees and increased use of services during and after the pandemic.
Recent national budget legislation enacted during the Trump administration has featured major proposals to lower federal Medicaid spending and restructure elements of the program. The “One Big Beautiful Bill Act,” for example, signed in 2025, is projected to decrease federal Medicaid support by over $1 trillion over the next decade, and introduces policies like work requirements and expanded cost-sharing. These measures are expected to reduce coverage and shift more costs to states, even as Medicaid supports tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $190,285 | -12% |
| 2021 | $129,621 | -31.9% |
| 2022 | $70,131 | -45.9% |
| 2023 | $2,416 | -96.6% |
| 2024 | $3,829 | 58.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $5,569,030 | 63.4% |
| 2 | National Codes Established for State Medicaid Agencies | $2,134,870 | 24.3% |
| 3 | Evaluation and Management | $617,802 | 7% |
| 4 | Ambulance and Other Transport Services and Supplies | $302,026 | 3.4% |
| 5 | Durable Medical Equipment | $97,369 | 1.1% |
| 6 | Pathology and Laboratory Procedures | $52,455 | 0.6% |
| 7 | Medicine Services and Procedures | $3,829 | <0.1% |
| 8 | Procedures / Professional Services | $1,066 | <0.1% |
| 9 | Medical And Surgical Supplies | $146 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90837 | Psytx w pt 60 minutes | $1,747 | 8 |
| 96127 | Brief emotional/behav assmt | $1,582 | 8 |
| 90471 | Immunization admin | $225 | 7 |
| 96160 | Pt-focused hlth risk assmt | $148 | 5 |
| 90472 | Immunization admin each add | $82 | 4 |
| 96372 | Ther/proph/diag inj sc/im | $41 | 1 |
| 90651 | 9vhpv vaccine 2/3 dose im | $0 | 1 |
| 90656 | Iiv3 vacc no prsv 0.5 ml im | $0 | 1 |
| 90734 | Menacwyd/menacwycrm vacc im | $0 | 2 |
| 90832 | Psytx w pt 30 minutes | $0 | 2 |
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.