Medicaid providers in Mountlake Terrace submitted $374,600 in claims for services classified under the Medicine Services and Procedures category in 2024, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a 41.6% rise over 2023, when providers billed $264,516 for the same type of care.
Medicaid is a public health insurance program administered by the states with funding provided jointly by federal and state governments. It offers coverage for low-income individuals and families, seniors, children, and people with disabilities, making up a significant portion of the U.S. health care system.
As Medicaid funds come from taxpayers, fluctuations in local billing highlight how public health expenditures are distributed at the community level.
The “Medicine Services and Procedures” category includes groups of Medicaid-eligible services defined by the type of care provided, structured around standardized HCPCS and CPT code groupings. In conducting this analysis, each billing code was linked to only one service category using standard code prefixes and numerical ranges, ensuring comparability, preventing double counting, and supporting accurate rankings over time.
Spending increased in multiple Medicaid service categories, with Medicine Services and Procedures ranking second by total Medicaid payments in Mountlake Terrace in 2024.
Statewide in Washington, Medicine Services and Procedures ranked third among all Medicaid categories for total payments in 2024.
From 2020 through 2024, Medicaid payments for Medicine Services and Procedures in Mountlake Terrace grew by $16,080, or 4.5%. The pace of increase picked up during some periods, with the largest year-to-year jumps occurring in 2022 and 2021.
Although care billed under Medicine Services and Procedures was recorded across Mountlake Terrace, payment amounts were concentrated in several ZIP codes. For 2024, ZIP code 98043 alone totaled $374,599 in Medicaid payments for these services. This represented 100% of the Medicine Services and Procedures-related Medicaid spend in Mountlake Terrace that year.
A small subset of billing codes accounted for most Medicaid dollars within the Medicine Services and Procedures category.
To give perspective, Medicaid spending tied to this service group in Mountlake Terrace grew 41.6% between 2024 and 2023, while total Medicaid claims for all categories citywide climbed 50.9% over the same timeframe.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid outlays rose to about $871.7 billion in fiscal year 2023, making up around 18% of national health spending, up significantly from approximately $613.5 billion in 2019 preceding the COVID-19 crisis.
This change amounts to nearly 40% growth within a few years, largely because of more enrollees and increased medical usage during and after the pandemic.
Congressional budget plans enacted under the Trump administration included many proposals for major federal Medicaid reductions and program restructuring. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is forecast to reduce federal Medicaid spending by over $1 trillion over 10 years. It instates work requirements and higher cost-sharing, which may decrease both coverage and funding for selected beneficiaries. The projected outcome is a shift in the Medicaid funding burden toward state governments and a cap on federal spending growth, even as tens of millions remain enrolled.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $358,520 | -30.5% |
| 2021 | $396,237 | 10.5% |
| 2022 | $454,554 | 14.7% |
| 2023 | $264,516 | -41.8% |
| 2024 | $374,599 | 41.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $958,464 | 58.6% |
| 2 | Medicine Services and Procedures | $374,599 | 22.9% |
| 3 | Evaluation and Management | $243,215 | 14.9% |
| 4 | Drugs Administered Other than Oral Method | $56,787 | 3.5% |
| 5 | Procedures / Professional Services | $2,071 | 0.1% |
| 6 | Pathology and Laboratory Procedures | $760 | <0.1% |
| 7 | Dental Services | $575 | <0.1% |
| 8 | Medical And Surgical Supplies | $194 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90999 | Unlisted dialysis procedure | $190,732 | 10 |
| 90833 | Psytx w pt w e/m 30 min | $145,613 | 40 |
| 92004 | Compre oph exam new pt 1/> | $15,773 | 12 |
| 90471 | Immunization admin | $5,848 | 13 |
| 92015 | Determine refractive state | $3,906 | 19 |
| 90836 | Psytx w pt w e/m 45 min | $3,865 | 1 |
| 90837 | Psytx w pt 60 minutes | $3,515 | 1 |
| 92340 | Fit spectacles monofocal | $1,378 | 5 |
| 96127 | Brief emotional/behav assmt | $1,238 | 11 |
| 90472 | Immunization admin each add | $971 | 3 |
| 96110 | Developmental screen w/score | $641 | 5 |
| 90480 | Admn sarscov2 vac 1/only cmp | $637 | 2 |
| 90656 | Iiv3 vacc no prsv 0.5 ml im | $425 | 8 |
| 91321 | Sarscov2 vac 25 mcg/.25ml im | $52 | 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.