Medicaid spending for procedures and professional services jumps 37.7% in Lafayette in 2024

Dr. Mehmet Oz CMS Administrator
Dr. Mehmet Oz CMS Administrator
0Comments

Lafayette Medicaid providers billed a total of $2,728,569 in 2024 for the Procedures / Professional Services category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 37.7% rise from 2023, when providers submitted $1,981,434 in claims for identical services.

Medicaid, a public health insurance initiative administered by individual states with joint federal and state funding, covers low-income people, seniors, children, and those with disabilities, making it a significant part of the nation’s health care system. Additional information can be found at the Commonwealth Fund explainer.

Local changes in Medicaid payment levels reflect how taxpayer-funded health care resources are distributed throughout the community.

The “Procedures / Professional Services” group includes several types of Medicaid-billed services, identified by standardized HCPCS and CPT code sets. In this analysis, each billing code was assigned to a distinct category using set code prefixes and numeric ranges. This method prevents duplicate counts and maintains precise tracking and comparisons year over year.

Although increases were seen across multiple categories, Procedures / Professional Services ranked fourth in total Medicaid payments for Lafayette during 2024.

The Procedures / Professional Services category held the fifth spot among all payment categories in Indiana for 2024.

Between 2019 and 2024, Medicaid payments associated with Procedures / Professional Services in Lafayette grew by $2,690,926, a jump of 7148.5%. Certain years saw especially fast growth, particularly with significant increases in both 2023 and 2022 compared to previous periods.

While these services were provided citywide, the highest payments were concentrated within a handful of ZIP codes. For 2024, ZIP code 47905 saw the largest Medicaid payments related to this category at $2,725,097, followed by 47904 at $3,470, and 47901 with $0. Collectively, the top 3 ZIP codes comprised the entire Medicaid spending for Procedures / Professional Services in Lafayette for the year.

Within the same category, a limited set of billing codes accounted for most payments.

To compare, Medicaid payments tied to the Procedures / Professional Services category in Lafayette increased 37.7% between 2023 and 2024, while overall Medicaid claims in the city rose by 35.8% during the same timeframe.

Centers for Medicare & Medicaid Services data show that federal and state Medicaid spending reached nearly $871.7 billion in fiscal year 2023, representing around 18% of total national health expenditures. That figure has climbed sharply from about $613.5 billion in 2019, prior to the COVID-19 outbreak.

This nearly 40% increase over a few years was mainly driven by expanded enrollment and greater usage during and after the pandemic period.

Recent federal budget measures during the Trump administration have included significant proposals to reduce federal Medicaid funding and reshape the program’s structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut over $1 trillion in federal Medicaid outlays over the next 10 years and brings policies such as work requirements and higher cost-sharing, which may decrease coverage and funding for some users. These changes could shift more financial responsibility to states, curbing federal Medicaid growth as the program continues to serve millions of Americans.

Medicaid Payments Tied to Procedures / Professional Services in Lafayette, Indiana Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $37,643 -12.6%
2021 $104,376 177.3%
2022 $300,656 188.1%
2023 $1,981,434 559%
2024 $2,728,568 37.7%
Top Categories by Medicaid Payments in Lafayette, Indiana, 2024

Rank Category Medicaid Payments Share of City Total
1 Alcohol and Drug Abuse Treatment $19,030,136 33.7%
2 Evaluation and Management $13,326,089 23.6%
3 Medicine Services and Procedures $9,036,279 16%
4 Procedures / Professional Services $2,728,568 4.8%
5 National Codes Established for State Medicaid Agencies $2,270,948 4%
6 Ambulance and Other Transport Services and Supplies $2,119,143 3.8%
7 Radiology Procedures $1,677,893 3%
8 Pathology and Laboratory Procedures $1,372,332 2.4%
9 Dental Services $1,257,687 2.2%
10 Surgery $1,160,909 2.1%
11 Temporary National Codes (Non-Medicare) $1,094,874 1.9%
12 Durable Medical Equipment $556,162 1%
13 Vision Services $363,847 0.6%
14 Medical And Surgical Supplies $239,317 0.4%
15 Drugs Administered Other than Oral Method $178,540 0.3%
16 Anesthesia $29,967 0.1%
17 Temporary Codes $14,565 <0.1%
18 Chemotherapy Drugs $9,025 <0.1%
19 Durable medical equipment (DME) Medicare administrative contractors (MACs) $4,861 <0.1%
Top 20 HCPCS Codes Within the Procedures / Professional Services Category in Lafayette, Indiana, 2024

HCPCS Code Description Medicaid Payments Claims
G2067 Med assist tx meth wk $2,301,833 12
G0480 Drug test def 1-7 classes $183,794 81
G0481 Drug test def 8-14 classes $145,906 53
G0463 Hospital outpt clinic visit $40,169 28
G2078 Take-home meth $37,448 11
G2077 Periodic assessment $8,892 9
G0410 Grp psych php/iop 45-50 $3,166 2
G2076 Intake act w/med exam $2,170 2
G0299 Hhs/hospice of rn ea 15 min $1,822 25
G0108 Diab manage trn per indiv $1,706 2
G9997 Doc pt preg dur msrmt pd $892 1
G0467 Fqhc visit, estab pt $470 7
G0155 Hhcp-svs of csw,ea 15 min $285 10
G2211 Complex e/m visit add on $9 13
G0008 Admin influenza virus vac $0 4
G0156 Hhcp-svs of aide,ea 15 min $0 18
G0300 Hhs/hospice of lpn ea 15 min $0 5
G1004 Cdsm ndsc $0 3
G8427 Docrev cur meds by elig clin $0 1
G8752 Sys bp less 140 $0 1

Note: HCPCS codes shown indicate context within the service category. All totals and rankings here are based on standard service groupings rather than specific billing codes.

The figures in this report are sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database, accessible here.



Related

Dr. Mehmet Oz CMS Administrator

Medicaid spending on Medicine Services and Procedures up 34.4% in Covington for 2024

Covington Medicaid providers billed $76,368 for Medicine Services and Procedures in 2024, representing a 34.4% increase compared to the prior year.

Dr. Mehmet Oz CMS Administrator

Frankfort Medicaid billing for pathology and laboratory services reaches $118,942 in 2024

Frankfort’s Medicaid providers received $118,942 in 2024 for Pathology and Laboratory Procedures, reflecting an 11.1% increase over the prior year.

Dr. Mehmet Oz CMS Administrator

Veedersburg Medicaid claims for ambulance and transport services reach $109,116 in 2024

In 2024, Medicaid providers in Veedersburg billed $109,116 for Ambulance and Other Transport Services and Supplies, representing a 190.2% increase from the prior year.

Trending

The Weekly Newsletter

Sign-up for the Weekly Newsletter from Lafayette Times.