In 2024, Medicaid providers in Rochester billed a total of $17,912 for the Medicine Services and Procedures category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented an 8.4% increase from 2023, when the same services led to $16,518 in claims.
Medicaid, operated by the states and funded in partnership with federal and state governments, provides health coverage to people with low incomes, older adults, children, and those with disabilities, making it a core component of the country’s health care system.
Because Medicaid is taxpayer funded, changes in how much is billed locally highlight how community health dollars are being spent.
The “Medicine Services and Procedures” category groups a range of services based on care type using standardized HCPCS and CPT code groupings. For this report, each billing code was classified into a service group using code prefixes and numeric ranges to ensure services are neither counted twice nor misclassified, preserving the accuracy of category rankings over time.
Among several Medicaid service spending categories, Medicine Services and Procedures led the way in Rochester in 2024 by total payments.
Statewide in Illinois, this category was the fifth-largest by total Medicaid outlays in 2024.
Medicaid spending related to Medicine Services and Procedures in Rochester rose $3,527, or 24.5%, during the five years ending in 2024. There were notable increases during some years, particularly in 2022 and 2023.
Most of the 2024 spending for Medicine Services and Procedures was attributed to a small number of ZIP codes. ZIP code 62563 accounted for $17,911, and the top 1 ZIP code together made up 100% of the Medicaid payments in this category for Rochester in 2024.
Spending within this category was also concentrated among few billing codes.
For context, the 8.4% gain in spending for Medicine Services and Procedures matched the 8.4% change seen across all Medicaid claim categories in Rochester for the same time frame.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending reached about $871.7 billion in fiscal 2023, or around 18% of all U.S. health expenditures—up from about $613.5 billion in 2019, before the COVID-19 pandemic.
This amounts to about 40% growth in just a few years, driven mostly by more enrollees and greater service use during and after the pandemic.
Legislation passed during the Trump administration introduced major plans to trim federal Medicaid support and restructure the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid funding by more than $1 trillion over the next ten years, creating new policies like work mandates and higher cost-sharing that could limit coverage and funding for certain groups. These moves are likely to put more financial burden on states and restrict federal growth in Medicaid while the program continues to serve millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $14,384 | -7.9% |
| 2021 | $14,405 | 0.1% |
| 2022 | $16,194 | 12.4% |
| 2023 | $16,517 | 2% |
| 2024 | $17,911 | 8.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $17,911 | 10<0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 92508 | Tx sp lang voice comm group | $11,700 | 10 |
| 96158 | Hlth bhv ivntj indiv 1st 30 | $5,467 | 7 |
| 90832 | Psytx w pt 30 minutes | $743 | 1 |
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.
