Mount Pocono sees 28.3% rise in Medicaid spending for Medicine Services and Procedures in 2024

In 2024, Medicaid providers in Mount Pocono billed $69,149 for services falling under the Medicine Services and Procedures category, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 28.3% rise from 2023, when providers reported $53,902 in claims for similar services.

Medicaid, operated by states and funded with both federal and state dollars, serves low-income people, families, seniors, children, and individuals with disabilities, making it one of the largest U.S. health care programs.

Since Medicaid expenses are taxpayer-funded, variations in local billing reflect how community health dollars are distributed.

The “Medicine Services and Procedures” category includes a group of Medicaid-billed services defined by the type of care provided, organized by standardized HCPCS and CPT code ranges. This report assigns each billing code to a single category based on consistent numeric and prefix criteria, ensuring related services are grouped together and accurate comparisons over time.

Medicaid spending grew in several service categories, with Medicine Services and Procedures placing fourth by total payments in Mount Pocono for 2024.

Across Pennsylvania, Medicine Services and Procedures held the third spot statewide for total Medicaid payments in 2024.

During the five years before 2024, Medicaid payments connected to the Medicine Services and Procedures category in Mount Pocono rose by $24,386, or 54.5%. Some years saw particularly strong growth, including significant year-over-year increases in 2021 and 2022.

Although spending in the Medicine Services and Procedures category was distributed within the city, the majority of payments were focused in a few ZIP codes. In 2024, ZIP code 18344 accounted for $69,148, representing 100% of Medicaid payments for this category in Mount Pocono that year.

Within Medicine Services and Procedures, a small selection of billing codes received most Medicaid payments.

Comparatively, Medicaid payments for Medicine Services and Procedures in Mount Pocono increased by 28.3% from 2023 to 2024, while overall Medicaid claim categories saw an 11.5% increase during the same timeframe.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached approximately $871.7 billion in fiscal 2023, about 18% of all U.S. health expenditures. This marks a steep rise from roughly $613.5 billion in 2019 before the COVID-19 pandemic.

This nearly 40% increase in a few years was mainly driven by expanding enrollment and higher service usage during and after the pandemic.

Recent federal budget measures under the Trump administration have proposed major reductions in federal Medicaid funding and changes to the program. The “One Big Beautiful Bill Act,” which became law in 2025, is anticipated to cut more than $1 trillion in federal Medicaid spending over the coming decade. It introduces measures such as work requirements and higher cost-sharing, which could lower funding and coverage for some recipients. As a result, additional costs may shift to states, potentially restricting federal Medicaid growth, even as the program continues to serve millions across the country.

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.