According to the U.S. Department of Health and Human Services Medicaid Provider Spending database, Medicaid providers in Presque Isle recorded $3,026,228 in billed amounts for Procedures / Professional Services in 2024. This represents a 1.6% uptick from 2023, when similar claims totaled $2,978,131.
Medicaid, administered by states and financed through a joint effort of federal and state governments, serves low-income households, seniors, children, and people with disabilities, making it one of the nation’s largest health system programs.
Since Medicaid is funded by taxpayers, changes in community-level billings indicate how public health resources are distributed locally.
The Procedures / Professional Services category encompasses services grouped based on standardized HCPCS and CPT coding schemes. For this reporting, each billing code was placed in a distinct service group using consistent prefixes and numeric sets, allowing related services to be collectively analyzed while preventing double counting and supporting reliable rankings over time.
While Medicaid spending grew across a range of categories, Procedures / Professional Services ranked third for total payments in Presque Isle in 2024.
Statewide in Maine, this category took the fourth position for Medicaid payment volume during the year.
Between 2019 and 2024, Medicaid payments in Presque Isle linked to Procedures / Professional Services grew by $672,054, up 28.5%. Growth accelerated in some years, with 2021 and 2022 showing the largest year-over-year gains.
Payment for Procedures / Professional Services was geographically distributed throughout the city, but concentrated largely within a single ZIP code in 2024. The area 04769 accounted for $3,026,227—representing 100% of all Medicaid-related Procedures / Professional Services outlays in Presque Isle that year.
A small group of billing codes received most of the Medicaid payments within Procedures / Professional Services.
Compared against a 1.6% rise for this care category between 2023 and 2024, overall Medicaid claims in Presque Isle increased by 10.5% across all service areas during this span.
According to the Centers for Medicare & Medicaid Services, combined Medicaid spending from federal and state sources hit about $871.7 billion in fiscal year 2023, accounting for around 18% of U.S. health expenditures—rising sharply from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.
This increase marks nearly 40% growth in a few years, largely because of increased enrollment and service use during and following the pandemic.
Recent federal budgets during the Trump administration have proposed major reductions to federal Medicaid funding and program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is predicted to cut more than $1 trillion in federal Medicaid outlays over a decade. These policies—which include added work conditions and higher cost sharing—could lessen both funding and coverage for some enrollees. These changes may require states to absorb greater costs and restrict federal Medicaid spending growth, even while the program serves several million Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $2,354,173 | 0.6% |
| 2021 | $2,614,051 | 11% |
| 2022 | $2,964,312 | 13.4% |
| 2023 | $2,978,131 | 0.5% |
| 2024 | $3,026,227 | 1.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $8,781,858 | 32.7% |
| 2 | National Codes Established for State Medicaid Agencies | $6,265,127 | 23.3% |
| 3 | Procedures / Professional Services | $3,026,227 | 11.3% |
| 4 | Evaluation and Management | $2,705,803 | 10.1% |
| 5 | Medicine Services and Procedures | $1,426,913 | 5.3% |
| 6 | Temporary National Codes (Non-Medicare) | $1,423,173 | 5.3% |
| 7 | Surgery | $902,243 | 3.4% |
| 8 | Ambulance and Other Transport Services and Supplies | $603,239 | 2.2% |
| 9 | Radiology Procedures | $522,552 | 1.9% |
| 10 | Durable Medical Equipment | $334,257 | 1.2% |
| 11 | Drugs Administered Other than Oral Method | $270,930 | 1% |
| 12 | Dental Services | $256,084 | 1% |
| 13 | Pathology and Laboratory Procedures | $187,966 | 0.7% |
| 14 | Medical And Surgical Supplies | $119,354 | 0.4% |
| 15 | Outpatient PPS | $10,388 | <0.1% |
| 16 | Orthotic Procedures and services | $5,960 | <0.1% |
| 17 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $5,086 | <0.1% |
| 18 | Temporary Codes | $3,710 | <0.1% |
| 19 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 19 | Vision Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0463 | Hospital outpt clinic visit | $2,326,150 | 12 |
| G9012 | Other specified case mgmt | $521,609 | 10 |
| G0299 | Hhs/hospice of rn ea 15 min | $70,917 | 12 |
| G0467 | Fqhc visit, estab pt | $68,766 | 11 |
| G0451 | Devlopment test interpt&rep | $16,224 | 11 |
| G0008 | Admin influenza virus vac | $14,603 | 11 |
| G2067 | Med assist tx meth wk | $5,818 | 4 |
| G0433 | Elisa hiv-1/hiv-2 screen | $937 | 7 |
| G0108 | Diab manage trn per indiv | $935 | 3 |
| G0378 | Hospital observation per hr | $125 | 10 |
| G2211 | Complex e/m visit add on | $114 | 6 |
| G0283 | Elec stim other than wound | $24 | 1 |
Note: HCPCS codes are provided for context within the category. Totals and rankings here are based on standardized groupings rather than individual billing codes to avoid duplication.
Data for this article comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original source is available here.