In 2024, Medicaid providers in Harrisburg invoiced $47,240,029 under the Procedures / Professional Services category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total reflects a 343.4% increase over 2023, when providers filed $10,653,357 in claims for these services.
Medicaid is a state-administered public health insurance program, supported through federal and state funding. The program offers coverage for low-income residents, the elderly, children and those with disabilities, making it a central component of the U.S. health care system.
Since Medicaid funding comes from taxpayers, shifts in local billing illustrate how public health care funds are distributed within a community.
The “Procedures / Professional Services” classification covers a selection of Medicaid-billed services identified by the nature of care, using standardized HCPCS and CPT code groupings. For this report, every billing code was placed within a single service grouping by matching code prefixes and number ranges, which enabled related services to be analyzed collectively and ensured accurate comparisons over time without duplication.
While Medicaid expenditures rose in several service categories, Procedures / Professional Services ranked as the leading category for total Medicaid payments in Harrisburg during 2024.
Statewide in Pennsylvania, Procedures / Professional Services was the fifth highest category by overall Medicaid payments in 2024.
During the five years preceding 2024, Medicaid payments linked to Procedures / Professional Services grew by $46,643,785, an increase of 7,822.9%. Growth in spending was particularly sharp in years such as 2020 and 2021.
Although spending for Procedures / Professional Services was distributed citywide, the majority of payments were concentrated within a small number of ZIP codes. In 2024, the areas with the largest Medicaid expenditures for this category were 17111, with $39,552,032; 17112, with $4,950,985; and 17110, with $1,621,482. Combined, the top 3 ZIP codes made up 97.6% of all Medicaid payments for Procedures / Professional Services in Harrisburg that year.
Within this category, Medicaid payments were also clustered among a few individual billing codes.
For additional context, Medicaid payments associated with Procedures / Professional Services in Harrisburg grew by 343.4% between 2024 and 2023. Across all Medicaid claim categories in the city, the change for the same period was 6.2%.
The Centers for Medicare & Medicaid Services reports that combined federal and state Medicaid expenditures reached about $871.7 billion in fiscal year 2023, making up about 18% of all national health care spending. That figure was up significantly from around $613.5 billion in 2019, prior to the COVID-19 pandemic.
This rise amounts to an estimated 40% growth in a few years, largely due to greater enrollment and expanded service use during and following the pandemic.
Recent federal budget laws enacted during the Trump administration included major proposals to reduce federal Medicaid spending and restructure program operations. For instance, the “One Big Beautiful Bill Act,” signed in 2025, is forecast to trim federal Medicaid support by more than $1 trillion over the next decade. The law adds policies such as work requirements and increased cost-sharing, which may reduce benefits and funding for some enrollees. These changes are expected to shift greater fiscal responsibility to states and slow the federal share of Medicaid growth, even as the program serves tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $596,243 | 31671.9% |
| 2021 | $3,193,272 | 435.6% |
| 2022 | $2,827,930 | -11.4% |
| 2023 | $10,653,357 | 276.7% |
| 2024 | $47,240,028 | 343.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Procedures / Professional Services | $47,240,028 | 32.4% |
| 2 | Alcohol and Drug Abuse Treatment | $41,369,014 | 28.4% |
| 3 | National Codes Established for State Medicaid Agencies | $26,118,950 | 17.9% |
| 4 | Medicine Services and Procedures | $9,708,764 | 6.7% |
| 5 | Evaluation and Management | $9,121,696 | 6.3% |
| 6 | Ambulance and Other Transport Services and Supplies | $8,085,414 | 5.5% |
| 7 | Temporary National Codes (Non-Medicare) | $1,633,285 | 1.1% |
| 8 | Pathology and Laboratory Procedures | $633,592 | 0.4% |
| 9 | Radiology Procedures | $596,512 | 0.4% |
| 10 | Dental Services | $367,061 | 0.3% |
| 11 | Medical And Surgical Supplies | $280,654 | 0.2% |
| 12 | Durable Medical Equipment | $246,138 | 0.2% |
| 13 | Vision Services | $180,213 | 0.1% |
| 14 | Surgery | $77,073 | 0.1% |
| 15 | Diagnostic Radiology Services | $30,683 | <0.1% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $22,207 | <0.1% |
| 17 | Anesthesia | $7,733 | <0.1% |
| 18 | Temporary Codes | $2,916 | <0.1% |
| 19 | Drugs Administered Other than Oral Method | $1 | <0.1% |
| 20 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 20 | Chemotherapy Drugs | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0156 | Hhcp-svs of aide,ea 15 min | $45,760,976 | 59 |
| G0378 | Hospital observation per hr | $747,086 | 24 |
| G9012 | Other specified case mgmt | $516,063 | 35 |
| G0176 | Opps/php/iop; activity thrpy | $171,959 | 21 |
| G0151 | Hhcp-serv of pt,ea 15 min | $17,602 | 5 |
| G0463 | Hospital outpt clinic visit | $13,809 | 53 |
| G0299 | Hhs/hospice of rn ea 15 min | $8,062 | 3 |
| G0127 | Trim nail(s) | $3,630 | 59 |
| G2211 | Complex e/m visit add on | $535 | 10 |
| G0279 | Tomosynthesis, mammo | $302 | 1 |
| G0008 | Admin influenza virus vac | $0 | 1 |
| G8404 | Low extemity neur exam docum | $0 | 4 |
| G8431 | Pos clin depres scrn f/u doc | $0 | 2 |
| G8510 | Scr dep neg, no plan reqd | $0 | 68 |
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.
