New Castle Medicaid claims for Procedures / Professional Services reach $1,162,618 in 2024

In 2024, Medicaid providers in New Castle reported $1,162,618 in claims for Procedures / Professional Services, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a 35.1% rise over 2023, when billings for the same services totaled $860,845.

Medicaid, a public health insurance initiative overseen by the states and financed by federal and state governments together, provides coverage for low-income individuals, families, seniors, children, and people with disabilities. It stands as a major component of the U.S. health care structure.

Because Medicaid funding is sourced from taxpayers, shifts in local billing volumes reflect how public health resources are allocated throughout the community.

The “Procedures / Professional Services” classification encompasses a range of Medicaid-billed offerings determined by the type of care delivered and based on established HCPCS and CPT code groupings. This analysis assigned each billing code to just one service category, using standard code prefixes and numerical ranges to group relevant services together and avoid duplicate counting while preserving accurate comparisons over time.

Though Medicaid expenditures increased in several service categories, Procedures / Professional Services ranked fifth by total Medicaid payments made in 2024 in New Castle.

Across Pennsylvania, Procedures / Professional Services placed fifth statewide by total payment amount in 2024.

During the five years prior to 2024, Medicaid payments for Procedures / Professional Services in New Castle rose by $1,125,913 for a 3067.4% gain. The pace of spending climbed at certain points, with particularly strong annual increases noted in 2021 and 2022.

Payments for Procedures / Professional Services were distributed throughout the city but primarily focused in a small number of ZIP codes. In 2024, ZIP code 16101 accounted for $1,162,617 in Medicaid payments under this category, while 16105 had $0. Combined, these 2 ZIP codes represented 100% of New Castle’s 2024 Medicaid payments for this group of services.

Within the Procedures / Professional Services group, Medicaid claims were concentrated on relatively few individual billing codes.

Comparatively, Medicaid claims for Procedures / Professional Services in New Castle jumped 35.1% from 2023 to 2024, contrasting with a 5.7% change for all Medicaid categories citywide during that time.

According to the Centers for Medicare & Medicaid Services, total Medicaid spending from federal and state sources reached approximately $871.7 billion in the 2023 fiscal year, which accounted for about 18% of national health expenditures. That marks a significant increase from $613.5 billion in 2019, preceding the COVID-19 pandemic.

This surge represents roughly 40% growth in only a few years, largely due to higher enrollment and increased program use during and following the pandemic period.

Recent federal budget laws under the Trump administration included major proposals to curtail federal Medicaid funding and alter the program’s structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is set to cut more than $1 trillion in federal Medicaid spending over the next decade, imposing work requirements and greater cost-sharing, which could shrink coverage and federal support for some beneficiaries. These updates are expected to shift a greater share of costs to states while placing limits on the future growth of federal Medicaid funding as the program continues to serve millions.

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.