Sebring Medicaid providers submitted $95,347 in claims for services designated as Procedures / Professional Services in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This figure represents a 45.1% rise compared with 2023, when $65,724 in claims were submitted for the same category of service.
Medicaid, a public health insurance program managed at the state level with joint federal and state funding, provides coverage for low-income families and individuals, seniors, children, and those with disabilities, making it a key segment of the U.S. health system.
Because taxpayer funds finance Medicaid, shifts in local spending reveal how health care resources are distributed within communities.
The “Procedures / Professional Services” classification includes various Medicaid services, grouped by the type of care provided and based on standard HCPCS and CPT codes. During this analysis, billing codes were consistently assigned to a unique category by matching code prefixes and numeric ranges, enabling related services to be analyzed together while ensuring proper rankings without code duplication over time.
Although Medicaid spending rose for several service categories, Procedures / Professional Services stood at 10th by total Medicaid expenditures in Sebring in 2024.
Statewide in Florida, the Procedures / Professional Services category also ranked 10th for overall Medicaid payments in 2024.
Across the five years preceding 2024, Sebring’s Medicaid spending for Procedures / Professional Services increased by $1,945, or 2%. Growth was especially marked in certain intervals, with significant year-over-year gains observed in 2022 and 2022.
Medicaid reimbursement in this category was distributed throughout Sebring, but payments saw significant concentration in particular ZIP codes. In 2024, ZIP code 33872 recorded $95,343 in claims, while 33870 received $3. These top 2 ZIP codes made up 100% of Sebring’s Medicaid expenditures for the Procedures / Professional Services category that year.
A small selection of billing codes accounted for most Medicaid payments in this category.
When compared to all Medicaid claim categories, Procedures / Professional Services saw a 45.1% rise in Sebring from 2023 to 2024, while overall Medicaid claims citywide climbed 42.9% during the same window.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending topped $871.7 billion in fiscal 2023, representing about 18% of total national health expenditures, and was up significantly from $613.5 billion in 2019 prior to the COVID-19 pandemic.
This increase represents roughly 40% growth over a span of a few years, mainly resulting from expanded enrollment and higher service utilization during and after the pandemic period.
Recent federal budget laws enacted during the Trump administration included major efforts to reduce federal Medicaid allocations and modify program rules. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to lower federal Medicaid funding by over $1 trillion over 10 years, adding policies like work requirements and higher cost-sharing that could restrict coverage and funding for some participants. These moves are anticipated to lead to more responsibilities for state governments and may slow future federal Medicaid funding growth, despite the program’s continued coverage for tens of millions nationally.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $97,292 | -12.9% |
| 2021 | $57,955 | -40.4% |
| 2022 | $73,512 | 26.8% |
| 2023 | $65,723 | -10.6% |
| 2024 | $95,346 | 45.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $4,780,804 | 56.1% |
| 2 | National Codes Established for State Medicaid Agencies | $1,772,096 | 20.8% |
| 3 | Medicine Services and Procedures | $470,393 | 5.5% |
| 4 | Ambulance and Other Transport Services and Supplies | $343,494 | 4% |
| 5 | Radiology Procedures | $287,953 | 3.4% |
| 6 | Alcohol and Drug Abuse Treatment | $203,253 | 2.4% |
| 7 | Surgery | $202,880 | 2.4% |
| 8 | Temporary National Codes (Non-Medicare) | $139,043 | 1.6% |
| 9 | Durable Medical Equipment | $136,907 | 1.6% |
| 10 | Procedures / Professional Services | $95,346 | 1.1% |
| 11 | Pathology and Laboratory Procedures | $81,906 | 1% |
| 12 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $4,520 | 0.1% |
| 13 | Drugs Administered Other than Oral Method | $3,518 | <0.1% |
| 14 | Medical And Surgical Supplies | $3,175 | <0.1% |
| 15 | Dental Services | $2,438 | <0.1% |
| 16 | Vision Services | $951 | <0.1% |
| 17 | Temporary Codes | $66 | <0.1% |
| 18 | Coronavirus Diagnostic Panel | $9 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0463 | Hospital outpt clinic visit | $95,343 | 35 |
| G2211 | Complex e/m visit add on | $3 | 6 |
| G0439 | Ppps, subseq visit | $0 | 1 |
| G0442 | Annual alcohol screen 15 min | $0 | 1 |
| G0444 | Depression screen annual | $0 | 1 |
| G0447 | Behavior counsel obesity 15m | $0 | 4 |
| G8417 | Calc bmi abv up param f/u | $0 | 1 |
| G8427 | Docrev cur meds by elig clin | $0 | 4 |
| G8431 | Pos clin depres scrn f/u doc | $0 | 4 |
| G8482 | Flu immunize order/admin | $0 | 3 |
| G8483 | Flu imm no admin doc rea | $0 | 7 |
| G8510 | Scr dep neg, no plan reqd | $0 | 12 |
| G8708 | Antibiotic not pres | $0 | 13 |
| G8752 | Sys bp less 140 | $0 | 2 |
| G8754 | Dias bp less 90 | $0 | 2 |
| G8783 | Bp scrn perf rec interval | $0 | 1 |
| G9744 | Pt not eli d/t act dig htn | $0 | 2 |
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.
