Procedures and professional services drive $3,826,222 in Medicaid billing in Seven Fields for 2024

In 2024, Medicaid providers in Seven Fields submitted $3,826,222 in claims for Procedures / Professional Services, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represents a 2.7% rise over 2023, during which time providers billed $3,724,101 for the same category of services.

Medicaid, funded by both federal and state governments and operated at the state level, provides health insurance to low-income individuals and families, seniors, children, and people with disabilities, making it a core component of the U.S. health care system. More details are available from the Commonwealth Fund.

Since public funds underpin Medicaid payments, changes in billing help illustrate how government health care money is allocated in local communities.

The “Procedures / Professional Services” group covers a range of Medicaid-approved services identified by standardized HCPCS and CPT code groupings. In compiling this analysis, each billing code was categorized under a single service type using unified code prefixes and numeric ranges. This method allows examination of related services together without double counting and preserves the validity of year-over-year comparisons.

Procedures / Professional Services saw the highest Medicaid spending among all service categories in Seven Fields for 2024, reflecting increases that extended to multiple service areas.

For Pennsylvania as a whole, the Procedures / Professional Services category was the fifth-largest by Medicaid spending in 2024.

Across the five years ending in 2024, Seven Fields Medicaid spending on Procedures / Professional Services jumped $3,037,694, a 385.2% gain. Some periods, including 2020 and 2021, showed pronounced annual growth.

Although these Medicaid expenditures occurred citywide, most of the payments stemmed from a small group of ZIP codes. Specifically for 2024, ZIP code 16046 accounted for $3,826,221 in payments, or 100% of all Medicaid Procedures / Professional Services bills in Seven Fields that year.

A small number of billing codes in the Procedures / Professional Services category accounted for the majority of Medicaid payments as well.

From 2023 to 2024, Procedures / Professional Services Medicaid payments in Seven Fields increased by 2.7%, outpacing the 2.4% rise in all Medicaid categories in the city during that interval.

The Centers for Medicare & Medicaid Services reports that combined state and federal Medicaid spending reached about $871.7 billion in fiscal year 2023, representing nearly 18% of total national health expenditures and up significantly from roughly $613.5 billion in 2019, before the COVID-19 pandemic.

This growth—about 40% over several years—was largely fueled by greater enrollment and increased usage of services during and after the pandemic.

Recent federal budget policies under the Trump administration have introduced significant proposed cuts to federal Medicaid funding and program restructuring. The “One Big Beautiful Bill Act,” enacted in 2025, is slated to reduce federal Medicaid spending by more than $1 trillion over the next 10 years while enacting work requirements and raising cost-sharing, potentially impacting coverage and funding for some beneficiaries. These measures may shift additional Medicaid financial responsibility to states and are expected to moderate the future growth of federal support, as the program continues providing coverage to tens of millions of Americans.

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.