Pleasant View Medicaid providers billed a total of $95,189 for medicine services and procedures in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This amount was 16.6% higher than the $81,609 claimed for the same category in 2023.
Medicaid is administered by the states and supported with joint state and federal funding. It serves low-income people and families, older adults, children, and those with disabilities, making it a major component of the nation’s health care system.
Because Medicaid relies on taxpayer funding, local billing changes reflect how health care funds are distributed in each community.
The “Medicine Services and Procedures” category includes various Medicaid-billed services defined by care type using standardized HCPCS and CPT groupings. For this analysis, each billing code was sorted into a single service group using standardized code ranges and prefixes to group related services, ensure results were not double-counted, and maintain comparable rankings across years.
Although several Medicaid service categories saw spending upswing, Medicine Services and Procedures was the second-largest in Pleasant View for total Medicaid payments in 2024.
Across Tennessee, the Medicine Services and Procedures category placed fifth in overall Medicaid payouts in 2024.
Between 2020 and 2024, Pleasant View saw Medicine Services and Procedures Medicaid payments climb by $40,723, representing a 74.8% rise. Notable year-over-year increases occurred in both 2023 and 2022.
In 2024, spending in this category was spread out, but most payments came from just a few ZIP codes. That year, ZIP code 37146 reported $95,188, accounting for 100% of all Pleasant View Medicaid payments for this category.
Additionally, a small group of individual billing codes accounted for most Medicaid payments within the Medicine Services and Procedures category.
For comparison, Pleasant View’s Medicine Services and Procedures Medicaid payments jumped 16.6% between 2024 and 2023, outpacing the 10% increase across all Medicaid claim categories in the city during the stated period.
According to the Centers for Medicare & Medicaid Services, federal and state spending on Medicaid totaled around $871.7 billion in fiscal year 2023, or about 18% of total national health expenditures—up from nearly $613.5 billion in 2019, before the COVID-19 pandemic.
This roughly 40% growth has been attributed mainly to broader enrollment and increased use of services during and after the pandemic.
Recent federal budget actions under the Trump administration featured major proposals for federal Medicaid funding cuts and program changes. The “One Big Beautiful Bill Act,” enacted in 2025, is forecast to reduce federal Medicaid spending by more than $1 trillion over 10 years and introduce measures like work requirements and higher cost-sharing, which could limit funding and coverage for some enrollees. These changes are projected to shift more costs onto states and curb further federal increases for Medicaid even as millions continue to rely on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $54,466 | -26.3% |
| 2021 | $40,007 | -26.5% |
| 2022 | $44,141 | 10.3% |
| 2023 | $81,609 | 84.9% |
| 2024 | $95,188 | 16.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $641,374 | 80.4% |
| 2 | Medicine Services and Procedures | $95,188 | 11.9% |
| 3 | Procedures / Professional Services | $28,424 | 3.6% |
| 4 | Dental Services | $21,372 | 2.7% |
| 5 | Pathology and Laboratory Procedures | $10,177 | 1.3% |
| 6 | Surgery | $979 | 0.1% |
| 7 | Drugs Administered Other than Oral Method | $108 | <0.1% |
| 8 | Other Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90837 | Psytx w pt 60 minutes | $31,246 | 12 |
| 96160 | Pt-focused hlth risk assmt | $24,532 | 34 |
| 90460 | Im admin 1st/only component | $19,767 | 24 |
| 96372 | Ther/proph/diag inj sc/im | $5,560 | 21 |
| 96127 | Brief emotional/behav assmt | $5,157 | 16 |
| 96110 | Developmental screen w/score | $3,018 | 10 |
| 93000 | Electrocardiogram complete | $1,919 | 10 |
| 90656 | Iiv3 vacc no prsv 0.5 ml im | $1,104 | 5 |
| 92551 | Pure tone hearing test air | $969 | 6 |
| 96365 | Ther/proph/diag iv inf init | $809 | 1 |
| 90471 | Immunization admin | $595 | 3 |
| 96161 | Caregiver health risk assmt | $507 | 7 |
| 90461 | Im admin each addl component | $0 | 5 |
| 90662 | Iiv no prsv increased ag im | $0 | 1 |
| 90677 | Pcv20 vaccine im | $0 | 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.