Sandpoint Medicaid providers billed $305,971 in 2024 for care categorized under Procedures / Professional Services, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This represents an 8.5% rise compared with 2023, when providers billed $282,012 for the same category.
Medicaid, a state-run program funded jointly by state and federal governments, provides health coverage to low-income families and individuals, seniors, children, and people with disabilities, making it among the largest components of the nation’s health care system.
Because Medicaid draws on tax revenue, changes in local billings offer insights into how community health care funding is distributed.
The Procedures / Professional Services category includes services grouped by the type of care provided, organized by standardized HCPCS and CPT codes. For this report, each code was designated to a single service category through consistent code prefixes and range assignments, ensuring accuracy in aggregate analysis and rankings over time by avoiding duplicate counts.
Procedures / Professional Services was the fifth-largest Medicaid spending category in Sandpoint for 2024, though Medicaid spending grew in several categories.
Statewide in Idaho, Procedures / Professional Services represented the sixth-highest payment category in 2024.
Over the five years ending in 2024, Medicaid payments for Procedures / Professional Services in Sandpoint climbed $152,953, equating to a 100% gain. Spending accelerated during select years, including sizable increases in 2023 and 2020.
Although care was delivered throughout Sandpoint, Medicaid billings were concentrated in a small number of ZIP codes. In 2024, ZIP code 83864 accounted for $305,971 in payments, reflecting 100% of local Medicaid spending in the Procedures / Professional Services category.
Payments in the Procedures / Professional Services category focused on a select group of individual billing codes.
When comparing years, Medicaid payments for this service group in Sandpoint went up by 8.5% from 2023 to 2024, whereas overall Medicaid claims across all categories grew by 1.7% in the city over that period.
Centers for Medicare & Medicaid Services figures indicate total Medicaid spending reached around $871.7 billion in fiscal 2023, making up nearly 18% of all national health expenditures, a substantial increase from about $613.5 billion in 2019 prior to the COVID-19 pandemic.
The difference signals growth of about 40% in just a few years, fueled largely by increased enrollment and higher service use during and after the pandemic.
Recent federal budget measures during the Trump administration introduced proposals to reduce federal Medicaid funding and alter program structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to trim more than $1 trillion from federal Medicaid allocations over the next decade and institutes changes such as work requirements and higher cost-sharing, with the potential to cut coverage and funds for certain groups. These adjustments are likely to put more cost burdens on states and curb federal Medicaid spending increases, even as Medicaid remains a core health program for tens of millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $153,018 | 23.5% |
| 2021 | $160,870 | 5.1% |
| 2022 | $191,380 | 19% |
| 2023 | $282,011 | 47.4% |
| 2024 | $305,971 | 8.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $1,798,478 | 38.9% |
| 2 | Medicine Services and Procedures | $774,604 | 16.8% |
| 3 | Alcohol and Drug Abuse Treatment | $618,365 | 13.4% |
| 4 | Evaluation and Management | $567,700 | 12.3% |
| 5 | Procedures / Professional Services | $305,971 | 6.6% |
| 6 | Dental Services | $240,086 | 5.2% |
| 7 | Temporary National Codes (Non-Medicare) | $103,341 | 2.2% |
| 8 | Ambulance and Other Transport Services and Supplies | $98,870 | 2.1% |
| 9 | Durable Medical Equipment | $73,435 | 1.6% |
| 10 | Medical And Surgical Supplies | $21,750 | 0.5% |
| 11 | Pathology and Laboratory Procedures | $13,763 | 0.3% |
| 12 | Surgery | $5,647 | 0.1% |
| 13 | Radiology Procedures | $2,160 | <0.1% |
| 14 | Drugs Administered Other than Oral Method | $136 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G9002 | Mccd,maintenance rate | $204,743 | 12 |
| G9007 | Mccd, sch team conf | $58,946 | 7 |
| G0482 | Drug test def 15-21 classes | $35,971 | 19 |
| G0467 | Fqhc visit, estab pt | $6,309 | 5 |
| G0008 | Admin influenza virus vac | $0 | 1 |
| G0511 | Ccm/bhi by rhc/fqhc 20min mo | $0 | 5 |
| G8510 | Scr dep neg, no plan reqd | $0 | 11 |
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.
