Portland providers billed $13,910,452 to Medicaid in 2024 for services included in the Procedures / Professional Services category, according to figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure is 2.7% higher than in 2023, when claims in the category totaled $13,539,426.
Medicaid is a public health insurance program run by each state and funded jointly by federal and state governments. The program provides health coverage for low-income residents, seniors, children and individuals with disabilities, making it one of the nation’s central health care programs.
Because Medicaid payments are taxpayer-funded, shifts in local billing help illustrate how community health care resources are distributed.
The “Procedures / Professional Services” classification combines a wide array of Medicaid services as defined by HCPCS and CPT code groupings. Each service in this study was assigned to one category, using standardized prefixes and number ranges to let related medical services be reviewed as a group without double counting or affecting rankings throughout the years.
While Medicaid outlays went up in several service categories, Procedures / Professional Services placed seventh among all Medicaid payment groups in Portland in 2024 by amount billed.
Statewide in Oregon, Procedures / Professional Services ranked eighth by total Medicaid payments in 2024.
During the five years before 2024, Portland Medicaid payments for Procedures / Professional Services grew by $8,246,444, marking a 145.6% jump. Some years saw heightened growth, especially with sizable annual increases in 2023 and 2021.
Spending for Procedures / Professional Services occurred citywide, but was mainly concentrated within a few ZIP codes. The top ZIP codes in 2024 by Medicaid payments in the category were 97239, which saw $8,082,017; 97216, which recorded $2,165,333; and 97209, totaling $1,367,685. These 3 areas combined for 83.5% of all Medicaid payments for Procedures / Professional Services within Portland that year.
Among categorized Procedures / Professional Services billings, a relatively small subset of codes drove the bulk of payments.
For comparison, Procedures / Professional Services category Medicaid claims in Portland rose 2.7% from 2023 to 2024, while Medicaid claims overall across all service types in the city saw a 13.1% change during the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures hit approximately $871.7 billion in fiscal year 2023. This figure represented around 18% of overall national health spending, up notably from roughly $613.5 billion in 2019 before the COVID-19 emergency.
That jump represents about 40% growth over several years, largely attributed to expanded enrollment and higher service use during and after the pandemic.
Recent federal budget policies during the Trump administration included proposals for major federal funding cuts and Medicaid reforms. The “One Big Beautiful Bill Act,” enacted in 2025, is forecast to reduce federal Medicaid contributions by over $1 trillion during the coming decade and adds provisions such as work requirements and higher cost-sharing. These policies may lower funding and coverage for some recipients, shifting more financial burden to states even as many Americans continue to depend on Medicaid.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $5,664,008 | -39.7% |
| 2021 | $8,111,902 | 43.2% |
| 2022 | $8,949,227 | 10.3% |
| 2023 | $13,539,426 | 51.3% |
| 2024 | $13,910,451 | 2.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $106,892,213 | 28.1% |
| 2 | Alcohol and Drug Abuse Treatment | $88,798,279 | 23.4% |
| 3 | Medicine Services and Procedures | $38,023,451 | 1<0.1% |
| 4 | National Codes Established for State Medicaid Agencies | $27,505,276 | 7.2% |
| 5 | Pathology and Laboratory Procedures | $25,315,662 | 6.7% |
| 6 | Temporary National Codes (Non-Medicare) | $16,866,793 | 4.4% |
| 7 | Procedures / Professional Services | $13,910,451 | 3.7% |
| 8 | Medical And Surgical Supplies | $11,482,786 | 3% |
| 9 | Drugs Administered Other than Oral Method | $9,962,612 | 2.6% |
| 10 | Radiology Procedures | $9,363,814 | 2.5% |
| 11 | Ambulance and Other Transport Services and Supplies | $7,629,979 | 2% |
| 12 | Durable Medical Equipment | $6,438,730 | 1.7% |
| 13 | Surgery | $5,135,060 | 1.4% |
| 14 | Enteral and Parenteral Therapy | $4,305,642 | 1.1% |
| 15 | Dental Services | $3,383,988 | 0.9% |
| 16 | Temporary Codes | $1,704,730 | 0.4% |
| 17 | Orthotic Procedures and services | $1,205,522 | 0.3% |
| 18 | Administrative, Miscellaneous and Investigational | $641,716 | 0.2% |
| 19 | Anesthesia | $566,302 | 0.1% |
| 20 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $386,827 | 0.1% |
| 21 | Vision Services | $196,371 | 0.1% |
| 22 | Prosthetic Procedures | $43,770 | <0.1% |
| 23 | Hearing Services | $6,479 | <0.1% |
| 24 | Diagnostic Radiology Services | $3,009 | <0.1% |
| 25 | Outpatient PPS | $2,338 | <0.1% |
| 26 | Miscellaneous Medical Services | $1,932 | <0.1% |
| 27 | Pathology and Laboratory Services | $1,548 | <0.1% |
| 28 | Chemotherapy Drugs | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0463 | Hospital outpt clinic visit | $9,432,812 | 4,024 |
| G9006 | Mccd, home monitoring | $1,571,140 | 15 |
| G2211 | Complex e/m visit add on | $692,097 | 2,864 |
| G9012 | Other specified case mgmt | $690,996 | 11 |
| G0480 | Drug test def 1-7 classes | $499,712 | 107 |
| G0328 | Fecal blood scrn immunoassay | $230,447 | 27 |
| G0121 | Colon ca scrn not hi rsk ind | $100,024 | 10 |
| G0330 | Facility svs dental rehab | $88,812 | 7 |
| G0444 | Depression screen annual | $76,653 | 79 |
| G2067 | Med assist tx meth wk | $59,743 | 57 |
| G0481 | Drug test def 8-14 classes | $55,916 | 8 |
| G0442 | Annual alcohol screen 15 min | $45,398 | 59 |
| G9002 | Mccd,maintenance rate | $40,000 | 2 |
| G0452 | Molecular pathology interpr | $36,019 | 37 |
| G0378 | Hospital observation per hr | $32,690 | 13 |
| G0300 | Hhs/hospice of lpn ea 15 min | $31,702 | 34 |
| G0299 | Hhs/hospice of rn ea 15 min | $30,979 | 86 |
| G0177 | Opps/php/iop; train & educ | $24,956 | 3 |
| G0105 | Colorectal scrn; hi risk ind | $21,131 | 3 |
| G0103 | Psa screening | $17,941 | 32 |
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.
