Salt Lake City Medicaid paid $88.7 million for Medicine Services and Procedures in 2024

Dr. Mehmet Oz CMS Administrator
Dr. Mehmet Oz CMS Administrator
0Comments

Medicaid providers invoiced $88,728,402 in Salt Lake City for Medicine Services and Procedures in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That figure is up 3.9% from 2023, when providers billed $85,368,310 for these services.

Medicaid is a state-administered program with joint state and federal funding provided by both levels of government. It helps cover medical costs for low-income people, older adults, families, children, and those with disabilities, making it a major component of the U.S. health care landscape.

Because taxpayer dollars ultimately fund Medicaid payments, shifts in local billing reflect how public health care money is distributed in the community.

The “Medicine Services and Procedures” classification groups Medicaid services by type of care, organized using standardized HCPCS and CPT coding systems. In this analysis, each billing code was mapped to a single service designation based on code prefixes and numeric intervals, which supports analysis of similar services together, allows accurate trend comparisons over time, and prevents double counting.

Medicine Services and Procedures had the highest Medicaid payment total among all categories in Salt Lake City during 2024, with increases noted across multiple service areas.

This category also ranked No. 1 statewide in Utah for Medicaid outlays in 2024.

In the five years before 2024, Medicaid payments for this category in Salt Lake City grew by $50,830,480, or 134.1%, with spending accelerating at certain points and significant annual increases recorded in both 2020 and 2021.

Spending on Medicine Services and Procedures was distributed citywide but heavily concentrated in specific ZIP codes. In 2024, three ZIP codes—84115 ($63,309,962), 84111 ($6,712,200), and 84124 ($3,522,889)—made up 82.9% of Salt Lake City’s Medicaid billings in the category.

Payments within the Medicine Services and Procedures category were similarly concentrated among a small set of billing codes.

From 2023 to 2024, Medicaid spending on this category rose 3.9% in Salt Lake City, while the aggregate across all Medicaid billing categories increased by 2.4% in the same timeframe.

According to the Centers for Medicare & Medicaid Services, Medicaid expenditures nationwide—combined state and federal—reached about $871.7 billion in fiscal year 2023, or approximately 18% of total national health spending, a sharp increase from roughly $613.5 billion in 2019 prior to the COVID-19 pandemic.

The roughly 40% rise over just a few years has been attributed principally to higher enrollment and increased demand during and after the pandemic.

Recent federal budget actions under the Trump administration have included major proposals aimed at cutting federal Medicaid support and restructuring the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid funding by over $1 trillion over 10 years and introduces work requirements along with higher cost-sharing, both of which could limit access and shift costs to states for some recipients. These policy changes are anticipated to further restrain the federal Medicaid growth rate while the program remains a critical coverage source for tens of millions of Americans.

Medicaid Payments Tied to Medicine Services and Procedures in Salt Lake City, Utah Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $37,897,921 37.9%
2021 $51,632,261 36.2%
2022 $63,959,863 23.9%
2023 $85,368,310 33.5%
2024 $88,728,402 3.9%
Top Categories by Medicaid Payments in Salt Lake City, Utah, 2024

Rank Category Medicaid Payments Share of City Total
1 Medicine Services and Procedures $88,728,402 29.1%
2 Alcohol and Drug Abuse Treatment $69,025,937 22.7%
3 Evaluation and Management $42,118,218 13.8%
4 National Codes Established for State Medicaid Agencies $29,612,025 9.7%
5 Ambulance and Other Transport Services and Supplies $26,347,478 8.7%
6 Pathology and Laboratory Procedures $18,891,463 6.2%
7 Temporary National Codes (Non-Medicare) $8,000,981 2.6%
8 Procedures / Professional Services $6,470,092 2.1%
9 Surgery $3,637,873 1.2%
10 Durable Medical Equipment $3,484,461 1.1%
11 Anesthesia $2,597,065 0.9%
12 Radiology Procedures $2,270,894 0.7%
13 Dental Services $1,289,578 0.4%
14 Medical And Surgical Supplies $1,057,240 0.3%
15 Drugs Administered Other than Oral Method $747,111 0.2%
16 Vision Services $96,799 <0.1%
17 Administrative, Miscellaneous and Investigational $55,595 <0.1%
18 Durable medical equipment (DME) Medicare administrative contractors (MACs) $46,270 <0.1%
19 Enteral and Parenteral Therapy $15,615 <0.1%
20 Orthotic Procedures and services $2,946 <0.1%
21 Temporary Codes $62 <0.1%
22 Outpatient PPS $0 <0.1%
Top 20 HCPCS Codes Within the Medicine Services and Procedures Category in Salt Lake City, Utah, 2024

HCPCS Code Description Medicaid Payments Claims
97153 Adaptive behavior tx by tech $50,903,517 21
97155 Adapt behavior tx phys/qhp $10,470,954 20
90837 Psytx w pt 60 minutes $8,010,337 312
90853 Group psychotherapy $3,785,771 86
97110 Therapeutic exercises $2,130,352 116
90791 Psych diagnostic evaluation $1,696,356 159
90834 Psytx w pt 45 minutes $1,467,653 132
97530 Therapeutic activities $1,352,392 133
97151 Bhv id assmt by phys/qhp $885,515 13
90832 Psytx w pt 30 minutes $818,541 142
97112 Neuromuscular reeducation $672,703 92
97156 Fam adapt bhv tx gdn phy/qhp $561,418 12
97140 Manual therapy 1/> regions $409,609 69
97162 Pt eval mod complex 30 min $337,810 59
92004 Compre oph exam new pt 1/> $335,362 48
92014 Compre oph exam est pt 1/> $281,939 57
97161 Pt eval low complex 20 min $277,817 46
90792 Psych diag eval w/med srvcs $276,513 44
92507 Tx sp lang voice comm indiv $251,931 58
90847 Family psytx w/pt 50 min $200,704 33

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.



Related

Dr. Mehmet Oz CMS Administrator

Alcohol and drug abuse treatment Medicaid payments total $932,442 in Cottonwood Heights for 2024

Cottonwood Heights Medicaid providers filed $932,442 in claims for Alcohol and Drug Abuse Treatment services in 2024, an increase of 4,568.5% compared to the prior year.

Dr. Mehmet Oz CMS Administrator

Murray Medicaid payments for Evaluation and Management services total $3,976,467 in 2024

Medicaid payments for the Evaluation and Management category rose 2.7% in Murray during 2024, signaling shifts in provider utilization and reimbursement trends.

Dr. Mehmet Oz CMS Administrator

South Salt Lake saw $599,597 in Medicaid claims for alcohol and drug treatment in 2024, a 151.3% jump

In 2024, Medicaid providers in South Salt Lake submitted $599,597 in claims for Alcohol and Drug Abuse Treatment, an increase of 151.3% compared to the previous year.

Trending

The Weekly Newsletter

Sign-up for the Weekly Newsletter from East SLC News.