Tualatin Medicaid providers billed $34,149 for services under the Procedures / Professional Services category in 2024, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 478% jump from 2023, when claims for this service type totaled $5,908.
Medicaid, a public health insurance program run by the states and financed jointly by federal and state governments, provides coverage to low-income individuals and families, seniors, children and people with disabilities. It is among the largest components of the U.S. health care system.
Since Medicaid is supported by taxpayers, fluctuations in local billing levels reflect how community public health care funds are distributed.
The “Procedures / Professional Services” category encompasses a set of Medicaid-billed services defined by care type, using standardized HCPCS and CPT code groupings. This analysis assigned each billing code to a single service category with consistent code prefixes and ranges, allowing comparisons across related services and accurate rankings over time while avoiding duplicate counts.
Although multiple service categories saw higher Medicaid spending, Procedures / Professional Services ranked as the eighth largest by payment total in Tualatin in 2024.
Statewide in Oregon, the Procedures / Professional Services category was also eighth for total Medicaid payments in 2024.
During the five years preceding 2024, Medicaid payments for the Procedures / Professional Services category in Tualatin grew by $18,220, or 114.4%. There were especially strong increases year-over-year in both 2023 and 2020.
Spending in this category, while citywide, was concentrated in certain ZIP codes. In 2024, ZIP code 97062 had the highest Medicaid billings for Procedures / Professional Services, totaling $34,149. This ZIP code accounted for all Medicaid payments in this category in Tualatin that year.
Within the Procedures / Professional Services category, most Medicaid payments were associated with a small subset of billing codes.
While Medicaid payments tied to Procedures / Professional Services surged by 478% in Tualatin from 2023 to 2024, overall Medicaid claim categories in the city grew by 10.9% for the same period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending totaled approximately $871.7 billion in fiscal 2023, comprising 18% of national health expenditures—up from about $613.5 billion before the COVID-19 pandemic in 2019.
This represents an increase of roughly 40% in a few years, propelled largely by increased enrollment and higher service use during and after the pandemic.
Recent federal budget measures during the Trump administration have featured major proposals for reduced federal Medicaid support and program restructuring. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years. New policies in the legislation, including work requirements and higher cost-sharing, are likely to reduce coverage and funding for some enrollees, shifting greater costs to states and slowing federal Medicaid growth even as the program serves tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $15,928 | 7.6% |
| 2021 | $759 | -95.2% |
| 2022 | $690 | -9.1% |
| 2023 | $5,907 | 756.2% |
| 2024 | $34,149 | 478.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $2,469,591 | 51% |
| 2 | Durable Medical Equipment | $606,917 | 12.5% |
| 3 | Medicine Services and Procedures | $572,610 | 11.8% |
| 4 | Radiology Procedures | $550,110 | 11.4% |
| 5 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $309,341 | 6.4% |
| 6 | Surgery | $201,337 | 4.2% |
| 7 | Alcohol and Drug Abuse Treatment | $55,421 | 1.1% |
| 8 | Procedures / Professional Services | $34,149 | 0.7% |
| 9 | Dental Services | $28,855 | 0.6% |
| 10 | Temporary Codes | $8,259 | 0.2% |
| 11 | National Codes Established for State Medicaid Agencies | $1,770 | <0.1% |
| 12 | Medical And Surgical Supplies | $1,482 | <0.1% |
| 13 | Pathology and Laboratory Procedures | $1,104 | <0.1% |
| 14 | Anesthesia | $815 | <0.1% |
| 15 | Pathology and Laboratory Services | $56 | <0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 16 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G2211 | Complex e/m visit add on | $28,896 | 133 |
| G0279 | Tomosynthesis, mammo | $5,253 | 21 |
| G0155 | Hhcp-svs of csw,ea 15 min | $0 | 12 |
| G0156 | Hhcp-svs of aide,ea 15 min | $0 | 11 |
| G0299 | Hhs/hospice of rn ea 15 min | $0 | 22 |
| G0300 | Hhs/hospice of lpn ea 15 min | $0 | 6 |
| G0480 | Drug test def 1-7 classes | $0 | 3 |
| G8907 | Pt doc no events on discharg | $0 | 3 |
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.
