Fayetteville Medicaid providers bill $290,050 for medicine services and procedures in 2024

Dr. Mehmet Oz CMS Administrator
Dr. Mehmet Oz CMS Administrator
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Fayetteville’s Medicaid providers billed a total of $290,050 for Medicine Services and Procedures in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure shows a 27.1% rise compared to 2023, when $228,211 in claims were submitted in the same category.

Medicaid is a public health insurance initiative managed by individual states and funded by both federal and state governments. It covers individuals and families with lower incomes, in addition to seniors, children, and people with disabilities, and remains a major component of the U.S. health care system.

Since Medicaid is funded by taxpayers, shifts in local billing amounts highlight how public health care finances are utilized within a community.

The “Medicine Services and Procedures” category includes a range of Medicaid-billed services identified by their care type, based on standardized HCPCS and CPT code groupings. For consistency, each billing code was grouped into a single service category using aligned code prefixes and number ranges. This approach allows related services to be grouped accurately, avoiding double counting and ensuring valid year-over-year ranking comparisons.

Medicaid outlays increased across various categories, but in Fayetteville, Medicine Services and Procedures came in as the second-highest by 2024 total payments.

At the state level, Tennessee ranked Medicine Services and Procedures fifth among all Medicaid payment categories in 2024.

During the five years before 2024, Medicaid payments in Fayetteville for this category grew by $246,125, which equates to 560.3%. Certain periods, such as 2021 and 2023, saw particularly strong increases over prior years.

Though spending for Medicine Services and Procedures was dispersed throughout Fayetteville, most payments were concentrated in a small number of ZIP codes. In 2024, ZIP code 37334 accounted for $290,050 in Medicaid payments, representing all claims in this category for the city that year.

A limited range of billing codes accounted for the bulk of Medicaid payments within the Medicine Services and Procedures category.

Between 2024 and 2023, Medicaid payments in Fayetteville for Medicine Services and Procedures rose by 27.1%, while overall Medicaid claims across all categories in the city reflected a 9.9% change for the same timeframe.

According to the Centers for Medicare & Medicaid Services, total national Medicaid spending, combining federal and state contributions, reached roughly $871.7 billion in fiscal year 2023, accounting for about 18% of national health expenditures. This marked a sharp increase from approximately $613.5 billion in 2019, prior to the COVID-19 pandemic.

This growth signals an increase of about 40% over just a few years, driven in large part by expanded enrollment and greater utilization throughout and following the pandemic period.

Federal budget laws passed during the Trump administration have introduced major proposals for reducing federal Medicaid support as well as restructuring the program. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is anticipated to reduce federal Medicaid spending by over $1 trillion in the next decade and establishes policies such as work requirements and higher cost-sharing. These provisions could limit funding and coverage for some beneficiaries and are expected to increase state responsibility for Medicaid-related costs even as the program continues to serve millions nationwide.

Medicaid Payments Tied to Medicine Services and Procedures in Fayetteville, Tennessee Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $43,924 -42.6%
2021 $129,191 194.1%
2022 $163,571 26.6%
2023 $228,210 39.5%
2024 $290,050 27.1%
Top Categories by Medicaid Payments in Fayetteville, Tennessee, 2024

Rank Category Medicaid Payments Share of City Total
1 Evaluation and Management $1,157,336 60.6%
2 Medicine Services and Procedures $290,050 15.2%
3 Ambulance and Other Transport Services and Supplies $166,878 8.7%
4 Pathology and Laboratory Procedures $135,096 7.1%
5 Durable Medical Equipment $66,632 3.5%
6 Surgery $37,282 2%
7 Alcohol and Drug Abuse Treatment $29,764 1.6%
8 Radiology Procedures $7,399 0.4%
9 Procedures / Professional Services $7,170 0.4%
10 Medical And Surgical Supplies $4,431 0.2%
11 Dental Services $3,101 0.2%
12 Vision Services $1,667 0.1%
13 Durable medical equipment (DME) Medicare administrative contractors (MACs) $1,406 0.1%
14 Drugs Administered Other than Oral Method $316 <0.1%
Top 20 HCPCS Codes Within the Medicine Services and Procedures Category in Fayetteville, Tennessee, 2024

HCPCS Code Description Medicaid Payments Claims
97153 Adaptive behavior tx by tech $166,087 26
90460 Im admin 1st/only component $39,763 21
97151 Bhv id assmt by phys/qhp $19,640 11
92507 Tx sp lang voice comm indiv $17,887 5
96110 Developmental screen w/score $17,653 12
96374 Ther/proph/diag inj iv push $6,831 28
96372 Ther/proph/diag inj sc/im $5,351 32
96375 Tx/pro/dx inj new drug addon $5,238 25
90471 Immunization admin $3,706 13
96365 Ther/proph/diag iv inf init $3,234 1
93005 Electrocardiogram tracing $1,363 23
90472 Immunization admin each add $1,173 8
93306 Tte w/doppler complete $512 1
90677 Pcv20 vaccine im $505 13
96361 Hydrate iv infusion add-on $336 4
90723 Dtap-hep b-ipv vaccine im $141 12
90619 Menacwy-tt vaccine im $129 1
90716 Var vaccine live subq $115 5
96127 Brief emotional/behav assmt $98 26
90680 Rv5 vacc 3 dose live oral $88 11

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.



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