Canton Medicaid payments for Medicine Services and Procedures climb to $2,502 in 2024

Providers billing Medicaid in Canton reported $2,502 in charges under the Medicine Services and Procedures category in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This figure represents a 12.7% rise from 2023, when $2,221 in claims were submitted for the same set of services.

Medicaid, a state-run and jointly federally funded insurance program, covers low-income people, families, older adults, children, and people with disabilities, making it a major part of the U.S. health care system. More on funding is available from the federal and state governments.

Taxpayer dollars fund Medicaid payments, so changes in billing amounts locally reflect how public health funds are distributed in a particular area.

The Medicine Services and Procedures category includes Medicaid-billed care identified by defined HCPCS and CPT codes. For this report, each billing code was classified in one service group based on code prefixes and numbers, which enabled analysis of grouped services, avoided counting service claims more than once, and maintained accurate rankings over time.

Among service categories with increased Medicaid spending, Medicine Services and Procedures ranked second by total payments in Canton in 2024.

Statewide in Maine, Medicine Services and Procedures ranked sixth for total Medicaid payments in 2024.

Between 2019 and 2024, Medicaid payments tied to Medicine Services and Procedures in Canton increased by $22,803, or 90.1%. There were especially sizable annual increases recorded in 2022 and 2022.

Spending on Medicine Services and Procedures in 2024 occurred citywide but was heavily concentrated within a small number of ZIP codes. That year, ZIP code 04221 alone generated $2,501 in Medicaid payments for the category. Together, the leading 1 ZIP code accounted for the entire Medicaid paid amount for Medicine Services and Procedures in Canton for 2024.

The category’s payments primarily concentrated among a handful of specific individual billing codes.

To compare, Medicaid spending on Medicine Services and Procedures in Canton rose 12.7% between 2023 and 2024, whereas the total for all Medicaid claim categories in the city increased by 3.3% in the same period.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached roughly $871.7 billion in fiscal 2023. That accounts for about 18% of total U.S. health expenditures, significantly higher than the approximately $613.5 billion spent in 2019, before the COVID-19 pandemic.

This reflects an approximate 40% spending increase over a few years, largely due to heightened enrollment and greater usage during and after the pandemic.

Under the Trump administration, recent federal budgets included major proposals to scale back federal Medicaid funding and alter program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is forecast to reduce federal Medicaid expenditures by more than $1 trillion over the next decade, including changes like work mandates and greater cost-sharing that could affect both coverage and access for beneficiaries. These changes mean states may have to take on more costs as federal Medicaid support growth slows, despite the program’s continued service to tens of millions across the nation.

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.