In 2024, Gresham Medicaid providers submitted $4,259,081 in billing for services grouped under Medicine Services and Procedures, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 5.7% rise over 2023, when claims for these services totaled $4,027,944.
Medicaid, the state-administered health insurance program funded in partnership by federal and state governments, provides coverage for low-income families, seniors, children, and individuals with disabilities, making it a major part of the American health care system.
As Medicaid is taxpayer-funded, shifts in billing highlight how public health care spending is distributed in the community.
The “Medicine Services and Procedures” category includes a range of Medicaid services, identified through standardized HCPCS and CPT coding. Each billing code was assigned to a single service class for this review by using set prefixes and number ranges, ensuring that related services could be tracked together. This process avoided duplicate counts and supported accurate annual rankings.
Spending on Medicaid increased in several categories, but Medicine Services and Procedures held the number 2 spot in Gresham for total Medicaid payments in 2024.
Statewide in Oregon, Medicine Services and Procedures placed third in overall Medicaid payments during 2024.
From 2019 through 2024, Medicaid payments associated with Medicine Services and Procedures in Gresham grew by $734,991, or 20.9%. This growth picked up pace at various times, with especially notable year-over-year gains recorded both in 2023 and 2022.
Although services in this category were provided throughout the city, most Medicaid payments were concentrated in a small number of ZIP codes. In 2024, ZIP code 97080 accounted for $2,625,532 and 97030 totaled $1,633,548. These 2 ZIP codes made up the entire total of Medicaid payments for the category in Gresham for the year.
Within the overall category, a small set of billing codes received most Medicaid payments.
Looking at broader patterns in the city, Medicaid payments for Medicine Services and Procedures rose by 5.7% between 2023 and 2024, while all Medicaid claim types together saw a 6.8% increase over the same period.
According to the Centers for Medicare & Medicaid Services, national spending for Medicaid reached about $871.7 billion in the 2023 fiscal year, totaling about 18% of national health expenses, up significantly from roughly $613.5 billion in 2019 prior to the COVID-19 pandemic.
This growth amounts to about 40% over a few years, largely attributed to greater enrollment numbers and increased use during and after the pandemic.
Recent federal budget measures during the Trump administration have contained substantial proposals to scale back federal Medicaid funding and reorganize the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid outlays by more than $1 trillion over 10 years while introducing changes such as work requirements and greater cost-sharing that may limit coverage and funding for some recipients. These revisions are likely to transfer greater financial responsibility to states and curb federal growth, although Medicaid will remain a critical source of coverage for millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $3,524,089 | -28% |
| 2021 | $3,462,121 | -1.8% |
| 2022 | $3,423,085 | -1.1% |
| 2023 | $4,027,944 | 17.7% |
| 2024 | $4,259,081 | 5.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $7,919,226 | 52.9% |
| 2 | Medicine Services and Procedures | $4,259,081 | 28.4% |
| 3 | National Codes Established for State Medicaid Agencies | $754,086 | 5% |
| 4 | Medical And Surgical Supplies | $416,208 | 2.8% |
| 5 | Surgery | $389,222 | 2.6% |
| 6 | Temporary National Codes (Non-Medicare) | $377,657 | 2.5% |
| 7 | Durable Medical Equipment | $329,493 | 2.2% |
| 8 | Alcohol and Drug Abuse Treatment | $224,058 | 1.5% |
| 9 | Radiology Procedures | $163,546 | 1.1% |
| 10 | Procedures / Professional Services | $64,258 | 0.4% |
| 11 | Vision Services | $40,418 | 0.3% |
| 12 | Dental Services | $35,480 | 0.2% |
| 13 | Pathology and Laboratory Procedures | $6,135 | <0.1% |
| 14 | Ambulance and Other Transport Services and Supplies | $179 | <0.1% |
| 15 | Administrative, Miscellaneous and Investigational | $51 | <0.1% |
| 16 | Drugs Administered Other than Oral Method | $34 | <0.1% |
| 17 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 97530 | Therapeutic activities | $1,389,837 | 160 |
| 92507 | Tx sp lang voice comm indiv | $944,617 | 149 |
| 96374 | Ther/proph/diag inj iv push | $595,975 | 158 |
| 90837 | Psytx w pt 60 minutes | $286,349 | 8 |
| 92004 | Compre oph exam new pt 1/> | $96,224 | 35 |
| 92340 | Fit spectacles monofocal | $94,263 | 41 |
| 96375 | Tx/pro/dx inj new drug addon | $91,858 | 100 |
| 97803 | Med nutrition indiv subseq | $87,781 | 43 |
| 97140 | Manual therapy 1/> regions | $81,908 | 36 |
| 93306 | Tte w/doppler complete | $71,812 | 30 |
| 97110 | Therapeutic exercises | $63,794 | 58 |
| 90999 | Unlisted dialysis procedure | $56,797 | 6 |
| 92523 | Speech sound lang comprehen | $48,481 | 15 |
| 90791 | Psych diagnostic evaluation | $44,692 | 10 |
| 96361 | Hydrate iv infusion add-on | $43,103 | 51 |
| 97124 | Massage therapy | $42,320 | 24 |
| 92609 | Use of speech device service | $36,752 | 10 |
| 92014 | Compre oph exam est pt 1/> | $25,526 | 17 |
| 96110 | Developmental screen w/score | $24,023 | 65 |
| 97113 | Aquatic therapy/exercises | $19,029 | 7 |
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.
