In 2024, Medicaid providers in Rock Springs charged a total of $255,211 for services in the Medicine Services and Procedures category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This was up 20.9% compared to 2023, when claims for the same category reached $211,098.
Medicaid is a publicly funded health insurance program, run at the state level but financed through both federal and state governments. It serves low-income people and families, seniors, children and individuals with disabilities, making it a key component of the U.S. health care system.
Since taxpayer funds support Medicaid, trends in local billing reveal how public dollars for health care are distributed within communities.
The “Medicine Services and Procedures” category consists of Medicaid-billed services identified by the type of care, classified using standard HCPCS and CPT code groupings. For this report, billing codes were placed into a single service category based on code prefixes and numeric ranges, which allows for aggregate analysis without double counting and maintains clear rankings over time.
Spending for Medicine Services and Procedures was among the larger increases in Rock Springs; in 2024, it ranked third for total Medicaid payments among all service categories.
Statewide in Wyoming, the Medicine Services and Procedures category was also the third largest by total Medicaid payments in 2024.
From 2020 through 2024, Medicaid payments tied to Medicine Services and Procedures in Rock Springs grew by $156,862, an increase of 159.5%. Notably, significant annual increases occurred in 2021 and 2022.
Although these services were available across Rock Springs, a small number of ZIP codes accounted for most payments. In 2024, ZIP code 82901 saw $255,211 in Medicaid payments for Medicine Services and Procedures. The top ZIP code made up 100% of Medicaid payments in this category for the year.
Within the Medicine Services and Procedures category, most Medicaid payments were focused on a few billing codes.
To compare, Medicaid payments for this category in Rock Springs rose by 20.9% between 2024 and 2023, while the increase across all Medicaid categories in the city during the same time was 14.9%.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached about $871.7 billion for fiscal year 2023. This equaled nearly 18% of all U.S. health expenditures, up from approximately $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This growth amounts to roughly 40% over several years, primarily due to increased enrollment and utilization following the pandemic.
Recent federal budget measures under the Trump administration included major plans to decrease federal Medicaid funding and alter program structure. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years and introduces measures such as work requirements and higher cost-sharing that may limit coverage and funding for some recipients. These changes are set to transfer more cost responsibility to states and slow federal Medicaid growth, even as the program continues to cover tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $98,349 | 9.5% |
| 2021 | $124,129 | 26.2% |
| 2022 | $178,264 | 43.6% |
| 2023 | $211,098 | 18.4% |
| 2024 | $255,211 | 20.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $3,120,152 | 61.7% |
| 2 | Evaluation and Management | $892,928 | 17.7% |
| 3 | Medicine Services and Procedures | $255,211 | 5% |
| 4 | Durable Medical Equipment | $203,019 | 4% |
| 5 | Vision Services | $103,090 | 2% |
| 6 | Alcohol and Drug Abuse Treatment | $95,263 | 1.9% |
| 7 | Temporary National Codes (Non-Medicare) | $79,804 | 1.6% |
| 8 | Enteral and Parenteral Therapy | $73,098 | 1.4% |
| 9 | Dental Services | $67,518 | 1.3% |
| 10 | Surgery | $61,674 | 1.2% |
| 11 | Pathology and Laboratory Procedures | $57,808 | 1.1% |
| 12 | Radiology Procedures | $22,046 | 0.4% |
| 13 | Medical And Surgical Supplies | $15,800 | 0.3% |
| 14 | Temporary Codes | $5,601 | 0.1% |
| 15 | Drugs Administered Other than Oral Method | $666 | <0.1% |
| 16 | Procedures / Professional Services | $116 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90837 | Psytx w pt 60 minutes | $99,350 | 31 |
| 90460 | Im admin 1st/only component | $46,448 | 35 |
| 92014 | Compre oph exam est pt 1/> | $32,705 | 19 |
| 96110 | Developmental screen w/score | $21,429 | 12 |
| 92015 | Determine refractive state | $10,687 | 27 |
| 92340 | Fit spectacles monofocal | $10,620 | 15 |
| 92004 | Compre oph exam new pt 1/> | $7,761 | 4 |
| 93976 | Vascular study | $6,764 | 7 |
| 92250 | Fundus photography w/i&r | $5,118 | 7 |
| 90853 | Group psychotherapy | $4,218 | 5 |
| 92083 | Extended visual field xm | $2,626 | 3 |
| 93306 | Tte w/doppler complete | $2,055 | 1 |
| 96374 | Ther/proph/diag inj iv push | $866 | 1 |
| 90677 | Pcv20 vaccine im | $763 | 19 |
| 93000 | Electrocardiogram complete | $749 | 5 |
| 94760 | N-invas ear/pls oximetry 1 | $740 | 9 |
| 96375 | Tx/pro/dx inj new drug addon | $476 | 1 |
| 90715 | Tdap vaccine 7 yrs/> im | $456 | 4 |
| 90697 | Dtap-ipv-hib-hepb vaccine im | $392 | 17 |
| 93227 | Xtrnl ecg rec<48 hr r&i | $279 | 1 |
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.
