In 2024, Medicaid providers in Enterprise billed a total of $2,665,818 for services categorized as Medicine Services and Procedures, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represents a 33.5% rise from 2023, when billings for the same service group amounted to $1,996,309.
Medicaid, the public health insurance program overseen by the states and financed by state and federal governments working together, provides coverage for low-income individuals and families, seniors, children, and those with disabilities. It constitutes a major portion of the U.S. health care infrastructure.
Since payments for Medicaid come from public sources, fluctuations in local billing reflect how public health spending is distributed within each area.
The “Medicine Services and Procedures” category encompasses a range of Medicaid-covered services grouped by the types of care provided, using standardized HCPCS and CPT codes. For this analysis, each billing code was matched to a single category based on prefix and numerical brackets, ensuring similar services were studied together while preventing duplicate counting and allowing for accurate comparisons over time.
Spending for Medicine Services and Procedures in Enterprise led all Medicaid categories by total dollars paid in 2024, with increases also tracked in various other service groups.
On a statewide basis, this category finished fourth in Alabama for total Medicaid payments in 2024.
From 2019 to 2024, Medicaid payments in Enterprise for Medicine Services and Procedures grew by $1,998,307—a 299.4% increase. The highest year-over-year spikes occurred during specific periods, notably in 2021 and 2020.
The bulk of funds for care in this category were paid to a concentrated set of ZIP codes across Enterprise. In 2024, ZIP code 36330 accounted for $2,665,817 in Medicaid payments tied to this category, making up 100% of all related Medicaid reimbursements in the city for the year.
Only a select number of billing codes within the Medicine Services and Procedures category accounted for most payment volume.
When comparing Enterprise’s trend, Medicine Services and Procedures payments climbed by 33.5% from 2023 to 2024—significantly outpacing the 4.9% overall increase seen across all Medicaid billing categories during that timeframe in the city.
Data from the Centers for Medicare & Medicaid Services reported that nationwide combined state and federal Medicaid spending reached about $871.7 billion for FY 2023—about 18% of total U.S. healthcare expenditures—up from around $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This growth represents a roughly 40% increase in only a few years, driven mainly by more enrollees and higher medical use during and following the pandemic.
Federal budget measures enacted during the Trump administration have included major proposals to reduce how much the federal government spends on Medicaid as well as to change the program’s structure. For example, the “One Big Beautiful Bill Act,” which became law in 2025, is expected to reduce federal Medicaid funds by more than $1 trillion over 10 years and set new policies including work mandates and greater cost-sharing. These changes could limit enrollment and reduce federal funding for some recipients, shifting additional costs to states even as Medicaid continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $667,510 | 83.7% |
| 2021 | $1,313,120 | 96.7% |
| 2022 | $1,339,065 | 2% |
| 2023 | $1,996,309 | 49.1% |
| 2024 | $2,665,817 | 33.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $2,665,817 | 49.6% |
| 2 | Evaluation and Management | $1,067,379 | 19.8% |
| 3 | Ambulance and Other Transport Services and Supplies | $504,720 | 9.4% |
| 4 | Surgery | $264,027 | 4.9% |
| 5 | Dental Services | $257,773 | 4.8% |
| 6 | National Codes Established for State Medicaid Agencies | $216,404 | 4% |
| 7 | Pathology and Laboratory Procedures | $144,783 | 2.7% |
| 8 | Temporary National Codes (Non-Medicare) | $107,938 | 2% |
| 9 | Radiology Procedures | $84,333 | 1.6% |
| 10 | Procedures / Professional Services | $36,117 | 0.7% |
| 11 | Anesthesia | $10,467 | 0.2% |
| 12 | Alcohol and Drug Abuse Treatment | $10,350 | 0.2% |
| 13 | Vision Services | $7,683 | 0.1% |
| 14 | Durable Medical Equipment | $1,320 | <0.1% |
| 15 | Temporary Codes | $521 | <0.1% |
| 16 | Drugs Administered Other than Oral Method | $228 | <0.1% |
| 17 | Medical And Surgical Supplies | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 97153 | Adaptive behavior tx by tech | $1,333,493 | 15 |
| 97156 | Fam adapt bhv tx gdn phy/qhp | $625,146 | 12 |
| 97155 | Adapt behavior tx phys/qhp | $357,727 | 12 |
| 97151 | Bhv id assmt by phys/qhp | $77,516 | 11 |
| 92014 | Compre oph exam est pt 1/> | $72,467 | 24 |
| 90837 | Psytx w pt 60 minutes | $57,511 | 23 |
| 92004 | Compre oph exam new pt 1/> | $43,293 | 15 |
| 90999 | Unlisted dialysis procedure | $37,651 | 6 |
| 92340 | Fit spectacles monofocal | $22,536 | 29 |
| 90833 | Psytx w pt w e/m 30 min | $17,602 | 12 |
| 92015 | Determine refractive state | $11,277 | 32 |
| 95117 | Immunotherapy injections | $2,912 | 9 |
| 93005 | Electrocardiogram tracing | $2,216 | 12 |
| 92250 | Fundus photography w/i&r | $1,317 | 2 |
| 93306 | Tte w/doppler complete | $1,086 | 1 |
| 92567 | Tympanometry | $944 | 5 |
| 92557 | Comprehensive hearing test | $513 | 1 |
| 93010 | Electrocardiogram report | $298 | 4 |
| 94640 | Airway inhalation treatment | $213 | 1 |
| 90785 | Psytx complex interactive | $93 | 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.
