Hershey-based Medicaid providers collected $9,618,217 for claims categorized under Medicine Services and Procedures in 2024, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 4.2% increase from the previous year, when $9,231,973 was billed for these services.
Medicaid functions as a public insurance program managed by states and financed collaboratively by federal and state governments. It provides coverage for low-income individuals and families, seniors, children, and people with disabilities, making it one of the biggest segments of the nation’s health system.
With Medicaid relying on taxpayer funding, fluctuations in local spending illustrate how health care resources are distributed within a community.
The “Medicine Services and Procedures” category includes a grouping of Medicaid services defined by specific care types, classified by standardized HCPCS and CPT code sets. Each billing code for this review was placed in a single service category using structured codes and ranges to enable aggregated analysis, avoid overlaps, and maintain accurate service rankings over time.
While multiple service categories saw Medicaid spending increases, Medicine Services and Procedures accounted for the most Medicaid payments in Hershey during 2024.
Within Pennsylvania overall, the Medicine Services and Procedures group ranked as the third-largest by Medicaid payments for the year.
From 2019 through 2024, Hershey’s Medicaid payments for this service group increased by $7,902,977, or 460.8%. Certain years, especially 2020 and 2021, saw especially strong annual increases.
Although spending in this category was distributed citywide, the amounts billed were concentrated within select ZIP codes. The largest amount in 2024 came from ZIP code 17033, totaling $9,618,217, with this area alone accounting for 100% of the city’s Medicaid payments for Medicine Services and Procedures that year.
A small number of specific billing codes accounted for much of the category’s Medicaid payments.
Hershey’s Medicine Services and Procedures’ Medicaid spending grew by 4.2% between 2024 and 2023, compared to an overall 5.2% increase in total Medicaid claims citywide during the same timeframe.
According to the Centers for Medicare & Medicaid Services, national Medicaid expenditures—federal plus state—reached about $871.7 billion in fiscal 2023, constituting roughly 18% of overall U.S. health spending. That figure marks a sharp run-up from the approximately $613.5 billion spent in 2019, prior to the COVID-19 pandemic.
This period represented nearly 40% growth, driven mainly by greater enrollment and use that increased during and after the pandemic.
Recent federal budget actions under the Trump administration have brought significant proposals to limit federal Medicaid outlays and redesign the program. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is forecast to reduce federal Medicaid funding by more than $1 trillion over the next ten years and includes new policies such as mandatory work requirements and greater cost-sharing. These changes may limit benefits and funding for certain groups and could require states to shoulder higher Medicaid costs while the program continues to provide for millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,715,240 | 1116% |
| 2021 | $8,357,092 | 387.2% |
| 2022 | $8,262,128 | -1.1% |
| 2023 | $9,231,973 | 11.7% |
| 2024 | $9,618,217 | 4.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $9,618,217 | 37.3% |
| 2 | Evaluation and Management | $9,418,771 | 36.5% |
| 3 | Procedures / Professional Services | $2,915,417 | 11.3% |
| 4 | Ambulance and Other Transport Services and Supplies | $1,181,530 | 4.6% |
| 5 | Orthotic Procedures and services | $901,341 | 3.5% |
| 6 | Surgery | $840,214 | 3.3% |
| 7 | Radiology Procedures | $523,119 | 2% |
| 8 | Pathology and Laboratory Procedures | $288,268 | 1.1% |
| 9 | Dental Services | $83,323 | 0.3% |
| 10 | Anesthesia | $16,375 | 0.1% |
| 11 | Temporary Codes | $23 | <0.1% |
| 12 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 12 | Chemotherapy Drugs | $0 | <0.1% |
| 12 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 97154 | Grp adapt bhv tx by tech | $6,658,215 | 12 |
| 90834 | Psytx w pt 45 minutes | $377,919 | 25 |
| 90837 | Psytx w pt 60 minutes | $301,142 | 30 |
| 95004 | Perq tests w/alrgnc xtrcs | $295,110 | 64 |
| 97155 | Adapt behavior tx phys/qhp | $226,871 | 12 |
| 95810 | Polysom 6/> yrs 4/> param | $184,090 | 13 |
| 94010 | Breathing capacity test | $167,688 | 103 |
| 92014 | Compre oph exam est pt 1/> | $116,877 | 81 |
| 92060 | Sensorimotor examination | $111,122 | 97 |
| 93304 | Echo transthoracic | $93,103 | 39 |
| 95117 | Immunotherapy injections | $78,881 | 70 |
| 96374 | Ther/proph/diag inj iv push | $75,385 | 25 |
| 93010 | Electrocardiogram report | $58,480 | 215 |
| 93005 | Electrocardiogram tracing | $57,950 | 78 |
| 92567 | Tympanometry | $55,972 | 158 |
| 93306 | Tte w/doppler complete | $52,872 | 36 |
| 90792 | Psych diag eval w/med srvcs | $52,687 | 11 |
| 92557 | Comprehensive hearing test | $50,810 | 58 |
| 92004 | Compre oph exam new pt 1/> | $44,626 | 17 |
| 93226 | Xtrnl ecg rec<48 hr scan a/r | $41,512 | 15 |
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.
