Medicaid spending on pathology and lab services in Waverly up 96.4% in 2024

In 2024, Medicaid providers in Waverly billed a total of $15,968 for services categorized under Pathology and Laboratory Procedures, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represents a 96.4% climb from 2023, when $8,132 in claims were submitted for these services.

Medicaid is a state-operated health insurance program funded together by federal and state governments. The program serves low-income people and families, seniors, children, and people with disabilities, making it one of the largest components of U.S. health care.

As Medicaid payments are supported by taxpayers, fluctuations in billing at the local level reflect how community health care funds are utilized.

The “Pathology and Laboratory Procedures” group includes a subset of Medicaid-billed services defined by types of care, using standard HCPCS and CPT code ranges and prefixes. For this report, each service code was mapped to a category so related items could be tracked together, while preventing overlap and ensuring accurate rankings across years.

Though overall Medicaid spending rose in several categories, Pathology and Laboratory Procedures was third in total Medicaid dollars disbursed in Waverly in 2024.

Statewide, Tennessee listed the Pathology and Laboratory Procedures category as sixth by total 2024 Medicaid payments.

Across the five-year period ending in 2024, Medicaid payments for Pathology and Laboratory Procedures in Waverly rose by $2,455, or 18.2%. Certain years, including 2020 and 2021, displayed notable increases in annual spending.

Spending in the Pathology and Laboratory Procedures category drew from multiple areas citywide, but most payments were concentrated in just a few ZIP codes. The area with the highest 2024 Medicaid payments for these services was 37185, totaling $15,967. That ZIP code represented 100% of all Waverly Medicaid payments in this category for the year.

Within this category, a small number of billing codes accounted for most Medicaid payments.

For comparison, Medicaid payments for Pathology and Laboratory Procedures surged 96.4% from 2023 to 2024 in Waverly, while citywide payments across all Medicaid claim categories rose 47% over the same period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached about $871.7 billion during fiscal year 2023, which made up roughly 18% of total U.S. health expenditures, rising sharply from around $613.5 billion in 2019, prior to the COVID-19 pandemic.

The increase marks roughly 40% growth over several years, driven mainly by more people enrolling and increased use during and in the aftermath of the pandemic.

Federal budget measures passed under the Trump administration have proposed extensive cuts to federal funding for Medicaid and program restructuring. For example, the “One Big Beautiful Bill Act,” which became law in 2025, is set to reduce federal Medicaid spending by more than $1 trillion over ten years and introduces work requirements and greater cost-sharing, potentially shrinking coverage and funding for some enrollees. The changes could lead to states taking on a larger share of program expenses and would restrict future federal funding growth, even as Medicaid remains essential to millions of Americans.

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.