Medicaid payments for medicine services in Royal Palm Beach hit $134,230 in 2024, rising 13.4%

Dr. Mehmet Oz CMS Administrator
Dr. Mehmet Oz CMS Administrator
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Royal Palm Beach providers billed $134,230 to Medicaid in 2024 for Medicine Services and Procedures, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount was 13.4% higher than the $118,327 recorded for similar services in 2023.

Medicaid is a state-run health insurance program with funding shared by federal and state governments. The program covers low-income residents, families, seniors, children, and individuals with disabilities. As one of the largest U.S. health care initiatives, it plays a central role in national coverage.

Local shifts in Medicaid billing patterns reflect how taxpayer-supported health care funds are distributed within a community.

The “Medicine Services and Procedures” grouping includes Medicaid-billed care determined by service type using standardized HCPCS and CPT code systems. This analysis classified each billing code into a single service group via established code prefixes and ranges to avoid duplication and keep rankings consistent over time.

Despite broad rises in Medicaid spending by category, Medicine Services and Procedures stood as the fourth-largest area by total Medicaid payments in Royal Palm Beach for 2024.

Within Florida, Medicine Services and Procedures ranked fifth among all service categories for total Medicaid payments the same year.

In the five years before 2024, Royal Palm Beach Medicaid spending for Medicine Services and Procedures increased $22,417, or 14.3%. Growth was particularly strong in select periods, including year-over-year gains seen in 2020 and 2021.

Payments in this category were spread citywide but were concentrated in a small number of ZIP codes. The largest share in 2024 came from ZIP code 33411, accounting for $134,229, or 100% of the city’s total within this category.

Spending within the Medicine Services and Procedures group was also concentrated on a limited number of individual billing codes.

Comparatively, Medicaid spending for the Medicine Services and Procedures group in Royal Palm Beach climbed by 13.4% between 2024 and 2023, while the combined total for all Medicaid claim categories in the city rose 35.6% during the same span.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid outlays totaled approximately $871.7 billion for fiscal year 2023, making up an estimated 18% of total national health expenditures. This reflects a sharp rise from $613.5 billion in 2019, before the onset of the COVID-19 pandemic.

The roughly 40% increase in expenditures over several years is attributed mainly to increased enrollment and greater service utilization related to the pandemic and its aftermath.

Federal budget actions during the Trump administration have featured major proposals to cut Medicaid funding and alter program structures. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is projected to reduce over $1 trillion in federal Medicaid spending over 10 years, introducing policies like work requirements and higher cost-sharing. These changes could reduce coverage for certain groups and are likely to require states to shoulder more of Medicaid’s cost burden while restricting federal funding growth.

Medicaid Payments Tied to Medicine Services and Procedures in Royal Palm Beach, Florida Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $156,646 203.2%
2021 $233,759 49.2%
2022 $337,850 44.5%
2023 $118,327 -65%
2024 $134,229 13.4%
Top Categories by Medicaid Payments in Royal Palm Beach, Florida, 2024

Rank Category Medicaid Payments Share of City Total
1 Evaluation and Management $178,343 23.5%
2 Procedures / Professional Services $150,970 19.9%
3 Temporary National Codes (Non-Medicare) $148,966 19.6%
4 Medicine Services and Procedures $134,229 17.7%
5 National Codes Established for State Medicaid Agencies $94,596 12.5%
6 Dental Services $50,581 6.7%
7 Pathology and Laboratory Procedures $1,198 0.2%
8 Surgery $202 <0.1%
9 Radiology Procedures $160 <0.1%
10 Durable medical equipment (DME) Medicare administrative contractors (MACs) $127 <0.1%
Top 20 HCPCS Codes Within the Medicine Services and Procedures Category in Royal Palm Beach, Florida, 2024

HCPCS Code Description Medicaid Payments Claims
97155 Adapt behavior tx phys/qhp $55,308 11
97112 Neuromuscular reeducation $39,417 18
97140 Manual therapy 1/> regions $18,802 16
90837 Psytx w pt 60 minutes $5,189 4
90960 Esrd srv 4 visits p mo 20+ $4,800 11
97156 Fam adapt bhv tx gdn phy/qhp $4,282 2
90460 Im admin 1st/only component $3,394 17
93306 Tte w/doppler complete $1,024 2
97802 Medical nutrition indiv in $717 6
92558 Evoked auditory test qual $560 9
96372 Ther/proph/diag inj sc/im $260 1
90961 Esrd srv 2-3 vsts p mo 20+ $235 2
90461 Im admin each addl component $204 3
94640 Airway inhalation treatment $30 1
90656 Iiv3 vacc no prsv 0.5 ml im $0 1
90686 Iiv4 vacc no prsv 0.5 ml im $0 1
90785 Psytx complex interactive $0 4
92551 Pure tone hearing test air $0 6
96160 Pt-focused hlth risk assmt $0 1
97014 Electric stimulation therapy $0 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.



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