Medicaid payments for medicine services climb 1.3% in Milwaukie in 2024

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

In 2024, Medicaid providers in Milwaukie submitted $3,453,811 in claims categorized under Medicine Services and Procedures, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 1.3% uptick compared to 2023, when the total was $3,408,977 for these same services.

Medicaid, a public health insurance program operated by the states and funded in partnership by the federal and state governments, provides coverage for low-income individuals and families, children, seniors, and those with disabilities. It represents one of the largest segments of the U.S. health care system.

Because taxpayer dollars are used to support Medicaid payments, fluctuations in local billing reveal how communities allocate public health care resources.

The “Medicine Services and Procedures” designation comprises a set of services for Medicaid billing, determined by specific types of care and grouped under standard HCPCS and CPT codes. For this report, service categories were established and grouped using code prefixes and numerical ranges to ensure comparable services could be analyzed accurately without duplication, maintaining consistency in rank and total over time.

Spending on Medicaid increased in several service areas; in 2024, Medicine Services and Procedures placed third by total Medicaid-related payments in Milwaukie.

Statewide in Oregon, this category also took the No. 3 spot in 2024 for total Medicaid payments.

Between 2019 and 2024, payments for Medicine Services and Procedures under Medicaid in Milwaukie rose by $1,992,280, equaling a 136.3% increase overall. Certain years, including 2023 and 2022, saw particularly strong year-over-year growth in this area.

Spending within the Medicine Services and Procedures category occurred throughout the city, though some ZIP codes captured the majority of payments. In 2024, ZIP code 97222 received the largest share, $2,021,224, and ZIP code 97267 followed with $1,432,586. Together, these top 2 ZIP codes represented 100% of Medicaid payments in this service category throughout Milwaukie for the year.

A significant portion of payments within Medicine Services and Procedures was associated with a select group of individual billing codes.

By comparison, these payments in Milwaukie went up by 1.3% between 2024 and 2023, whereas all Medicaid claim categories combined only saw a change of 0.2% locally in the same period.

Data from the Centers for Medicare & Medicaid Services shows that national Medicaid spending by federal and state governments together reached approximately $871.7 billion in the 2023 fiscal year. This accounted for about 18% of total national health expenditures, up from $613.5 billion in 2019, before the pandemic.

This jump reflects growth of roughly 40% over several years, primarily resulting from expanded Medicaid enrollment and increased use following the COVID-19 pandemic.

Under the Trump administration, recent federal budget measures have proposed substantial cuts to federal Medicaid support and program restructuring. For instance, the “One Big Beautiful Bill Act,” which became law in 2025, is expected to reduce federal Medicaid outlays by more than $1 trillion across the next decade. The legislation also implements policies such as work requirements and more cost-sharing, changes that could affect beneficiary coverage and state funding. The result may be a shift of fiscal responsibilities to states and constraints on growth in federal Medicaid contributions, but the program continues to assist tens of millions nationwide.

Medicaid Payments Tied to Medicine Services and Procedures in Milwaukie, Oregon Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $1,461,531 -11%
2021 $1,684,072 15.2%
2022 $2,373,093 40.9%
2023 $3,408,976 43.7%
2024 $3,453,811 1.3%
Top Categories by Medicaid Payments in Milwaukie, Oregon, 2024

Rank Category Medicaid Payments Share of City Total
1 Evaluation and Management $4,314,948 27%
2 Alcohol and Drug Abuse Treatment $3,971,743 24.9%
3 Medicine Services and Procedures $3,453,811 21.6%
4 Ambulance and Other Transport Services and Supplies $1,149,778 7.2%
5 National Codes Established for State Medicaid Agencies $1,025,554 6.4%
6 Drugs Administered Other than Oral Method $907,836 5.7%
7 Durable Medical Equipment $263,506 1.7%
8 Surgery $256,693 1.6%
9 Medical And Surgical Supplies $205,881 1.3%
10 Durable medical equipment (DME) Medicare administrative contractors (MACs) $107,467 0.7%
11 Pathology and Laboratory Procedures $81,835 0.5%
12 Procedures / Professional Services $74,338 0.5%
13 Anesthesia $61,515 0.4%
14 Temporary National Codes (Non-Medicare) $36,233 0.2%
15 Dental Services $21,706 0.1%
16 Temporary Codes $12,230 0.1%
17 Radiology Procedures $10,440 0.1%
Top 20 HCPCS Codes Within the Medicine Services and Procedures Category in Milwaukie, Oregon, 2024

HCPCS Code Description Medicaid Payments Claims
96165 Hlth bhv ivntj grp ea addl $833,297 26
90837 Psytx w pt 60 minutes $599,900 61
92014 Compre oph exam est pt 1/> $463,207 225
92004 Compre oph exam new pt 1/> $354,887 144
97124 Massage therapy $263,985 43
96164 Hlth bhv ivntj grp 1st 30 $170,553 26
96374 Ther/proph/diag inj iv push $170,123 71
92015 Determine refractive state $121,474 322
97110 Therapeutic exercises $103,731 30
92134 Cptrz oph dx img pst sgm rta $102,605 68
92340 Fit spectacles monofocal $48,739 33
92507 Tx sp lang voice comm indiv $29,324 12
96375 Tx/pro/dx inj new drug addon $27,563 36
97140 Manual therapy 1/> regions $21,724 17
90791 Psych diagnostic evaluation $20,757 5
96361 Hydrate iv infusion add-on $19,569 27
92083 Extended visual field xm $18,551 26
92060 Sensorimotor examination $18,429 16
92133 Cptrzd oph dx img pst sgm on $17,939 46
93010 Electrocardiogram report $11,635 57

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.



Related

Dr. Mehmet Oz CMS Administrator

Lake Oswego Medicaid providers bill $393,485 for Evaluation and Management services in 2024

Providers in Lake Oswego submitted Medicaid claims totaling $393,485 for Evaluation and Management services in 2024, reflecting a 0.2% uptick compared with the prior year.

Kyle Diamantas, J.D., Deputy Commissioner for Human Foods of FDA

Washington County cities: 3 companies received FDA inspections in Q1

There were three companies in cities associated with Washington County that received three FDA inspections in the first quarter of 2026, according to the U.S. Food and Drug Administration.

Melanie Keller, Deputy Commissioner for Operations and Chief Operating Officer of FDA

3 companies in cities within Clackamas County received three inspections in Q1

There were three companies in cities associated with Clackamas County that received three FDA inspections in the first quarter of 2026, according to the U.S. Food and Drug Administration.

Trending

The Weekly Newsletter

Sign-up for the Weekly Newsletter from East PDX Today.