In 2024, providers in Vail billed $633,075 to Medicaid for services falling under the Medicine Services and Procedures category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 49.8% increase from 2023, when $422,578 in claims were submitted for this category of service.
Medicaid is a government health insurance program operated by states with joint funding from both state and federal governments together. It provides coverage for low-income people, families, seniors, children, and individuals with disabilities, ranking as one of the largest programs in the U.S. health care system.
Because tax dollars fund Medicaid, fluctuations in local billing levels reflect how community health funds are spent.
The “Medicine Services and Procedures” category comprises a set of Medicaid-billed services determined by the type of treatment provided, using standardized HCPCS and CPT code groupings. For these metrics, each billing code was assigned to a single service group based on consistent code prefixes and number ranges, so related services could be compared and accurately tracked over time.
Medicine Services and Procedures accounted for the highest Medicaid billing total in Vail for 2024, outpacing other service categories.
Statewide in Arizona, Medicine Services and Procedures placed fifth in Medicaid payment totals for 2024.
Over the five-year period leading up to 2024, Medicaid payments linked to Medicine Services and Procedures in Vail grew by $611,700, representing an increase of 2861.7%. Notable surges in spending were seen in 2021 and 2022.
Though costs for Medicine Services and Procedures were incurred citywide, the majority of payments were focused in a small number of ZIP codes. For 2024, ZIP code 85641 alone accounted for $633,075, making up 100% of Vail’s Medicaid payments for this category.
Within the larger service category, a small subset of individual billing codes represented most Medicaid payments.
To compare, the 49.8% increase in Vail’s Medicaid payments for Medicine Services and Procedures from 2023 to 2024 far exceeded the 10.2% rise observed across all claim categories in the city during that same timeframe.
The Centers for Medicare & Medicaid Services reported that total state and federal Medicaid spending was about $871.7 billion in fiscal year 2023. This comprised nearly 18% of all U.S. health spending and was a sizable jump from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This change reflects approximately 40% overall growth within a few years, driven mainly by higher enrollment and greater use of services during and after the pandemic.
Recent legislation passed during the Trump administration brought notable proposals to curtail federal Medicaid expenditures and modify the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to slash over $1 trillion from federal Medicaid budgets in the coming decade, while introducing new work requirements and increased cost sharing, with the potential effect of reducing access for some recipients. These changes may shift added costs to states and curtail the future expansion of federal Medicaid contributions, despite the program’s ongoing service to tens of millions nationally.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $21,375 | 7.9% |
| 2021 | $159,849 | 647.8% |
| 2022 | $351,325 | 119.8% |
| 2023 | $422,577 | 20.3% |
| 2024 | $633,075 | 49.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $633,075 | 62.1% |
| 2 | Temporary National Codes (Non-Medicare) | $259,431 | 25.4% |
| 3 | Ambulance and Other Transport Services and Supplies | $104,212 | 10.2% |
| 4 | National Codes Established for State Medicaid Agencies | $21,647 | 2.1% |
| 5 | Procedures / Professional Services | $871 | 0.1% |
| 6 | Evaluation and Management | $519 | 0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 97530 | Therapeutic activities | $214,859 | 41 |
| 97112 | Neuromuscular reeducation | $183,082 | 40 |
| 97110 | Therapeutic exercises | $97,409 | 37 |
| 97140 | Manual therapy 1/> regions | $51,770 | 37 |
| 97535 | Self care mngment training | $50,350 | 24 |
| 97161 | Pt eval low complex 20 min | $23,082 | 17 |
| 97016 | Vasopneumatic device therapy | $5,971 | 11 |
| 92508 | Tx sp lang voice comm group | $4,431 | 17 |
| 97162 | Pt eval mod complex 30 min | $1,591 | 1 |
| 97014 | Electric stimulation therapy | $526 | 1 |
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.
