Pathology and laboratory Medicaid outlays total $81,218 in Plain City for 2024

Plain City Medicaid providers billed $81,218 for Pathology and Laboratory Procedures services in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This amount reflects a 10787.1% jump compared to 2023, when these services accounted for $746 in claims.

Medicaid, a public health insurance program overseen by states and funded by both federal and state governments, provides coverage for low-income individuals, children, people with disabilities and seniors, making it a major segment of the U.S. health care system.

Taxpayer dollars support Medicaid payments, meaning changes in local billing directly indicate how public health care funds are distributed in different communities.

The “Pathology and Laboratory Procedures” classification refers to Medicaid-reimbursed services identified by the type of care using standardized HCPCS and CPT codes. This report assigned each billing code to a single service grouping based on code prefixes and number ranges, enabling analysis of related services, accurate ranking over time and prevention of double-counting.

While several Medicaid service categories posted higher spending, Pathology and Laboratory Procedures finished second in Plain City by total Medicaid payments in 2024.

Statewide, Pathology and Laboratory Procedures ranked seventh in Ohio based on total payments for 2024.

From 2019 to 2024, Plain City’s Medicaid payments in the Pathology and Laboratory Procedures category increased by $1,226,465, or 93.8%, with notable annual spending spikes in 2020 and 2022.

Though Medicaid spending for Pathology and Laboratory Procedures was spread across Plain City, disbursements were heavily concentrated in a few ZIP codes. In 2024, the 43064 ZIP code accounted for $81,218, making up 100% of the city’s Medicaid payments for this service category that year.

A small set of individual billing codes were responsible for the majority of Medicaid payments within the Pathology and Laboratory Procedures category.

In comparison, between 2023 and 2024, Plain City’s Medicaid spending for Pathology and Laboratory Procedures soared by 10787.1%, while the increase across all Medicaid categories for the city was 12.9% over the same period.

According to the Centers for Medicare & Medicaid Services, total combined federal and state Medicaid spending was approximately $871.7 billion in fiscal year 2023, representing about 18% of all national health expenditures, up markedly from $613.5 billion in 2019 before the COVID-19 pandemic.

This increase amounts to a roughly 40% rise in just a few years, due mainly to higher enrollment and greater use of services during the pandemic and in its aftermath.

Recent federal budget measures under the Trump administration have included major proposals to limit federal Medicaid funding and alter the program structure. The “One Big Beautiful Bill Act,” enacted in 2025, aims to cut federal Medicaid spending by more than $1 trillion over the next 10 years, introducing policies such as work requirements and increased cost-sharing that could reduce access and funding for some recipients. This is expected to increase the financial burden on states and could restrict the growth of federal support to Medicaid, even as the program continues to cover tens of 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.