In 2024, Edmonds Medicaid providers submitted $1,224,520 in claims for Medicine Services and Procedures, U.S. Department of Health and Human Services Medicaid Provider Spending database data show. This figure reflects a 2.6% rise over 2023, when $1,193,536 was billed for similar services in the city.
Medicaid, a joint federal and state program managed by the states, covers low-income people, seniors, children, and individuals with disabilities, making it one of the United States’ largest health care programs. Federal and state governments share its funding, according to the Commonwealth Fund.
Because tax revenue funds Medicaid payments, fluctuations in local billing reflect how public health dollars are distributed in specific communities.
The Medicine Services and Procedures category encompasses a specific set of Medicaid-billed services, grouped by standard HCPCS and CPT code classifications. This analysis designated each billing code to one service category, based on consistent code prefixes and numerical ranges, enabling related procedures to be reviewed together and ensuring accurate rankings while avoiding duplication.
Medicine Services and Procedures placed second in overall Medicaid payments among service categories in Edmonds in 2024, during a period when several other categories also saw spending growth.
Statewide in Washington, Medicine Services and Procedures held the third spot among all Medicaid categories for total payments in 2024.
From 2019 through 2024, Edmonds recorded a 5.6% increase—$72,681—in Medicaid payments associated with the Medicine Services and Procedures category. Certain intervals within this period, particularly in 2021 and 2022, saw heightened year-over-year spending growth.
Although payments for Medicine Services and Procedures were made across Edmonds, the majority were concentrated in a few ZIP codes. For 2024, ZIP code 98026 accounted for $1,026,973 and 98020 for $197,546. Combined, these two ZIP codes represented the entirety of Medicaid Medicine Services and Procedures payments for the city during the year.
Payments within the Medicine Services and Procedures category in Edmonds were focused on a relatively narrow group of billing codes.
Looking at growth rates among Medicaid claims, spending for Medicine Services and Procedures rose 2.6% between 2024 and 2023 in Edmonds, whereas the average increase across all Medicaid categories in the city was 8.5% during that same timeframe.
According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid expenditures reached $871.7 billion in fiscal year 2023, accounting for about 18% of national health spending—an increase from $613.5 billion reported in 2019, prior to the COVID-19 pandemic.
This jump amounts to growth of roughly 40% over several years, with enrollment expandsions and higher utilization cited as major factors during and after the pandemic era.
Recent federal legislation passed under the Trump administration has featured broad proposals to cut federal Medicaid support and adjust program structure. The “One Big Beautiful Bill Act,” enacted in 2025, is forecast to reduce federal Medicaid expenditures by more than $1 trillion through the coming decade. The law introduces requirements such as work participation and increases cost-sharing for beneficiaries, measures expected to lower participation and federal funding. These changes are projected to shift greater financing responsibility to states while restricting future federal Medicaid spending, even as the program provides coverage to millions across the U.S.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,297,200 | -16.6% |
| 2021 | $1,428,640 | 10.1% |
| 2022 | $1,280,797 | -10.3% |
| 2023 | $1,193,536 | -6.8% |
| 2024 | $1,224,519 | 2.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $2,435,371 | 36.3% |
| 2 | Medicine Services and Procedures | $1,224,519 | 18.2% |
| 3 | National Codes Established for State Medicaid Agencies | $950,589 | 14.2% |
| 4 | Radiology Procedures | $831,387 | 12.4% |
| 5 | Surgery | $505,661 | 7.5% |
| 6 | Medical And Surgical Supplies | $265,533 | 4% |
| 7 | Pathology and Laboratory Procedures | $262,061 | 3.9% |
| 8 | Procedures / Professional Services | $225,520 | 3.4% |
| 9 | Temporary National Codes (Non-Medicare) | $5,788 | 0.1% |
| 10 | Dental Services | $4,776 | 0.1% |
| 11 | Temporary Codes | $920 | <0.1% |
| 12 | Drugs Administered Other than Oral Method | $187 | <0.1% |
| 13 | Administrative, Miscellaneous and Investigational | $3 | <0.1% |
| 14 | Outpatient PPS | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 96361 | Hydrate iv infusion add-on | $395,870 | 11 |
| 90837 | Psytx w pt 60 minutes | $353,662 | 60 |
| 93306 | Tte w/doppler complete | $91,113 | 11 |
| 96366 | Ther/proph/diag iv inf addon | $64,840 | 10 |
| 96365 | Ther/proph/diag iv inf init | $51,045 | 11 |
| 96360 | Hydration iv infusion init | $34,733 | 10 |
| 97110 | Therapeutic exercises | $25,372 | 11 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | $24,446 | 3 |
| 97112 | Neuromuscular reeducation | $17,946 | 11 |
| 93017 | Cv stress test tracing only | $17,396 | 10 |
| 97530 | Therapeutic activities | $14,971 | 11 |
| 97535 | Self care mngment training | $13,545 | 11 |
| 97140 | Manual therapy 1/> regions | $13,251 | 11 |
| 93350 | Stress tte only | $13,228 | 4 |
| 90661 | Cciiv3 vac abx fr 0.5 ml im | $11,003 | 3 |
| 93970 | Extremity study | $10,306 | 6 |
| 90480 | Admn sarscov2 vac 1/only cmp | $7,995 | 3 |
| 90471 | Immunization admin | $7,992 | 15 |
| 95810 | Polysom 6/> yrs 4/> param | $6,571 | 1 |
| 97597 | Dbrdmt opn wnd 1st 20 cm/< | $6,186 | 4 |
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.
