Dayton Medicaid spending for procedures, professional services jumps 25.5% in 2024

In 2024, Medicaid providers in Dayton submitted $21,591 in claims for services categorized as Procedures / Professional Services, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. That total represents a 25.5% rise over 2023, when similar service claims amounted to $17,201.

Medicaid, a public health insurance program jointly funded by state and federal governments, covers families and individuals with low incomes, seniors, children, and people with disabilities. It is a cornerstone of the U.S. health care system and ranks among its largest programs.

Because taxpayer dollars support Medicaid, local shifts in payment volumes reflect changes in how those public funds are distributed for medical care.

The “Procedures / Professional Services” grouping spans multiple Medicaid-billed services, defined using standardized HCPCS and CPT code groupings that correspond to the kind of care billed. This analysis assigns each billing code to one service category with consistent code prefixes and ranges, ensuring accurate comparisons and preventing double counting across categories.

While Medicaid spending rose in many service groups, Procedures / Professional Services held the seventh spot for total Medicaid payments in Dayton for 2024.

Statewide in Tennessee, Procedures / Professional Services also ranked seventh among Medicaid service categories by total payments in 2024.

Between 2019 and 2024, Dayton’s Medicaid payments for Procedures / Professional Services grew by $11,624, representing a 35% increase. The rise became more pronounced in select periods, with particularly strong year-over-year growth in 2023 and 2022.

Although care in this category was delivered across Dayton, payments were largely focused in a handful of ZIP codes. In 2024, ZIP code 37321 accounted for $21,590 in Medicaid payments tied to Procedures / Professional Services. This sole ZIP code represented 100% of such Medicaid payments in Dayton that year.

Payments within the Procedures / Professional Services group were also mostly allocated via a small range of billing codes.

For context, the 25.5% increase for Procedures / Professional Services in Dayton between 2024 and 2023 contrasts with a 50% rise across all Medicaid claim categories citywide over the same period.

The Centers for Medicare & Medicaid Services reports that national Medicaid spending, combining both state and federal contributions, reached about $871.7 billion in fiscal year 2023. That figure represents roughly 18% of total national health spending and marks a sharp increase from approximately $613.5 billion in 2019, prior to the COVID-19 pandemic.

This overall growth—roughly 40% over several years—largely stems from broader enrollment and increased utilization linked to the pandemic and its aftermath.

Legislation enacted during the Trump administration has included broad efforts to reduce federal Medicaid funding and shift program structure. The “One Big Beautiful Bill Act,” signed in 2025, is projected to lower federal Medicaid expenditures by over $1 trillion over the next 10 years and brings requirements—such as work criteria and greater cost-sharing—that could reduce the number of people eligible for coverage and shift greater responsibilities to individual states. Such measures are likely to restrict federal Medicaid growth even while millions across the country continue to depend on the program for health care.

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.