In 2024, Medicaid providers in Grants Pass submitted $254,188 in claims for Administrative, Miscellaneous and Investigational services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total reflects a 25.1% increase over 2023, when providers billed $203,234 for the same service category.
Medicaid, a public health insurance program, is administered by states and receives funding from both federal and state governments. It offers coverage for low-income individuals and families, seniors, children, and people with disabilities, making it a significant component of the national health care system.
Because taxpayer funding supports Medicaid payments, shifts in billing locally illustrate how public health funds are directed within a community.
The “Administrative, Miscellaneous and Investigational” category groups Medicaid services according to standardized HCPCS and CPT codes. In this report, individual billing codes were grouped into a single service category using specific code prefixes and numerical ranges, facilitating the analysis of similar services together and ensuring accurate rankings while preventing double counting.
Administrative, Miscellaneous and Investigational services ranked ninth by total Medicaid spending in Grants Pass in 2024, though Medicaid expenditures went up across multiple categories that year.
At the state level, this category ranked 20th for total Medicaid payments in Oregon in 2024.
From 2019 to 2024, Medicaid spending for Administrative, Miscellaneous and Investigational services in Grants Pass climbed by $94,880, a 59.6% increase. The most substantial year-over-year increases occurred in 2020 and 2023.
Although spending on these services was distributed throughout Grants Pass, most payments came from a small group of ZIP codes. In 2024, ZIP code 97527 accounted for $246,580 in Medicaid payments, while ZIP code 97526 saw $7,607. These 2 ZIP codes together represented 100% of Medicaid payments for this category in the city during 2024.
Payments within this service category were primarily attributed to a few specific Medicaid billing codes.
Medicaid payments for Administrative, Miscellaneous and Investigational services in Grants Pass increased 25.1% between 2023 and 2024. For comparison, all Medicaid claim categories in the city rose by 14.5% during the same period.
According to the Centers for Medicare & Medicaid Services, combined federal and state spending on Medicaid reached approximately $871.7 billion for the 2023 fiscal year, making up about 18% of national health care spending. This figure increased from around $613.5 billion in 2019, prior to the COVID-19 pandemic.
This growth represents an approximate 40% increase over several years, driven mainly by higher enrollment and service use during and after the pandemic.
Recent federal budget measures under the Trump administration proposed major reductions to federal Medicaid funding and structural program changes. The “One Big Beautiful Bill Act,” enacted in 2025, aims to reduce federal Medicaid spending by over $1 trillion in the next 10 years, also adding work requirements and increased cost-sharing that may decrease coverage and funding for some recipients. These changes are anticipated to shift additional costs to states and slow the growth of federal Medicaid support, even as the program continues to serve tens of millions across the country.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $159,308 | 21.4% |
| 2021 | $175,617 | 10.2% |
| 2022 | $170,369 | -3% |
| 2023 | $203,233 | 19.3% |
| 2024 | $254,187 | 25.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $5,882,790 | 34.6% |
| 2 | Medicine Services and Procedures | $4,389,094 | 25.8% |
| 3 | National Codes Established for State Medicaid Agencies | $1,835,117 | 10.8% |
| 4 | Procedures / Professional Services | $988,202 | 5.8% |
| 5 | Ambulance and Other Transport Services and Supplies | $913,594 | 5.4% |
| 6 | Alcohol and Drug Abuse Treatment | $788,830 | 4.6% |
| 7 | Radiology Procedures | $546,680 | 3.2% |
| 8 | Dental Services | $430,505 | 2.5% |
| 9 | Administrative, Miscellaneous and Investigational | $254,187 | 1.5% |
| 10 | Temporary National Codes (Non-Medicare) | $180,795 | 1.1% |
| 11 | Pathology and Laboratory Procedures | $180,775 | 1.1% |
| 12 | Temporary Codes | $178,424 | 1.1% |
| 13 | Surgery | $163,794 | 1% |
| 14 | Orthotic Procedures and services | $120,243 | 0.7% |
| 15 | Hearing Services | $71,601 | 0.4% |
| 16 | Vision Services | $49,028 | 0.3% |
| 17 | Durable Medical Equipment | $7,957 | <0.1% |
| 18 | Medical And Surgical Supplies | $6,241 | <0.1% |
| 19 | Outpatient PPS | $30 | <0.1% |
| 20 | Drugs Administered Other than Oral Method | $4 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| A9279 | Monitoring feature/devicenoc | $131,607 | 12 |
| A9280 | Alert device, noc | $114,973 | 12 |
| A9901 | Delivery/set up/dispensing | $6,639 | 5 |
| A9276 | Disposable sensor, cgm sys | $737 | 1 |
| A9575 | Inj gadoterate meglumi 0.1ml | $230 | 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.
