Edmond Medicaid providers billed $2,841,974 for Procedures / Professional Services in 2024, according to figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents a 25.3% increase compared with 2023, when $2,267,848 was billed for the same services.
Medicaid, a public health insurance program operated by states and funded through joint federal and state support, covers people with low incomes, seniors, children, and individuals with disabilities. It is one of the principal segments of the U.S. health care system.
Since taxpayer contributions support Medicaid funding, fluctuations in local billing levels indicate how public health care resources are allocated within a community.
The “Procedures / Professional Services” group includes Medicaid-billed services categorized by the specific type of care, as determined from standardized HCPCS and CPT code systems. In this reporting, each code was placed within one service category using consistent code prefixes and numerical ranges to analyze related services as a set, avoid double counting, and maintain comparable rankings over time.
Though overall Medicaid spending grew in several service categories, Procedures / Professional Services stood as the fourth-largest by total Medicaid payments in Edmond for 2024.
Statewide in Oklahoma, Procedures / Professional Services held the fifth position by total Medicaid payment for 2024.
Between 2019 and 2024, Medicaid spending connected to Procedures / Professional Services in Edmond rose by $2,396,018, or 537.3%. Certain periods of growth saw payments accelerate, particularly in 2022 and 2021.
While spending in this service category was distributed across Edmond, payments were largely concentrated in select ZIP codes. In 2024, ZIP code 73012 accounted for $2,426,624, 73034 posted $415,350, and 73003 recorded $0 in Medicaid payments for these services. Collectively, these top 3 ZIP codes represented 100% of all Medicaid payments tied to Procedures / Professional Services in Edmond that year.
A limited selection of specific billing codes saw the largest share of Medicaid payments within the Procedures / Professional Services group.
When compared with other Medicaid claims in Edmond, Procedures / Professional Services showed a 25.3% payment increase from 2023 to 2024, while all Medicaid claim categories combined rose by 23.6% over the same period.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending amounted to approximately $871.7 billion in fiscal 2023, making up about 18% of total U.S. health expenditures. This was up from roughly $613.5 billion in 2019, ahead of the COVID-19 pandemic.
This increase translates to around 40% growth in less than five years, spurred in large part by increased enrollment and higher service usage during and following the pandemic.
Recent federal budget actions during the Trump administration have proposed substantial reductions in federal Medicaid funding alongside program restructuring. Notably, the “One Big Beautiful Bill Act,” enacted in 2025, is forecasted to reduce federal Medicaid spending by over $1 trillion over the next 10 years, introducing policy changes such as work requirements and greater cost-sharing for some enrollees. These provisions could reduce both coverage and funding for affected beneficiaries, leading to increased responsibilities for states as federal commitments moderate while the program continues to serve millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $445,955 | 26.3% |
| 2021 | $781,869 | 75.3% |
| 2022 | $1,492,250 | 90.9% |
| 2023 | $2,267,848 | 52% |
| 2024 | $2,841,974 | 25.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $11,886,574 | 40.6% |
| 2 | Evaluation and Management | $6,700,845 | 22.9% |
| 3 | Medicine Services and Procedures | $2,957,732 | 10.1% |
| 4 | Procedures / Professional Services | $2,841,974 | 9.7% |
| 5 | Alcohol and Drug Abuse Treatment | $1,500,175 | 5.1% |
| 6 | Pathology and Laboratory Procedures | $1,249,388 | 4.3% |
| 7 | Dental Services | $530,106 | 1.8% |
| 8 | Drugs Administered Other than Oral Method | $453,034 | 1.5% |
| 9 | Anesthesia | $249,350 | 0.9% |
| 10 | Surgery | $199,605 | 0.7% |
| 11 | Durable Medical Equipment | $152,916 | 0.5% |
| 12 | Orthotic Procedures and services | $138,112 | 0.5% |
| 13 | Ambulance and Other Transport Services and Supplies | $136,148 | 0.5% |
| 14 | Diagnostic Radiology Services | $94,634 | 0.3% |
| 15 | Medical And Surgical Supplies | $50,277 | 0.2% |
| 16 | Radiology Procedures | $41,213 | 0.1% |
| 17 | Temporary National Codes (Non-Medicare) | $24,639 | 0.1% |
| 18 | Vision Services | $22,178 | 0.1% |
| 19 | Chemotherapy Drugs | $19,451 | 0.1% |
| 20 | Temporary Codes | $9,236 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0151 | Hhcp-serv of pt,ea 15 min | $1,434,786 | 19 |
| G0152 | Hhcp-serv of ot,ea 15 min | $889,043 | 42 |
| G0153 | Hhcp-svs of s/l path,ea 15mn | $518,144 | 40 |
| G0447 | Behavior counsel obesity 15m | $0 | 17 |
| G9920 | Scrning perf and negative | $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.
