South Bend Medicaid providers reported $1,897,194 in charges for the Procedures / Professional Services category in 2024, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 53.6% rise from 2023, when $1,235,089 in claims were submitted for these services.
Medicaid is a joint federal and state public health insurance initiative. It serves low-income families and individuals, seniors, children, and people with disabilities. This makes it one of the largest health care program components in the U.S. Program funding is provided jointly by federal and state governments.
Because public taxpayer dollars fund Medicaid payments, shifts in local billing activity highlight how health funds are distributed throughout a community.
The “Procedures / Professional Services” classification groups Medicaid-billed procedures by the type of care, as determined by standardized HCPCS and CPT codes. For this report, each billing code was assigned to a single service group based on its prefix and numeric range, which facilitates direct comparisons over time without double counting or distorting the rankings.
Despite increases in Medicaid outlays among numerous categories, Procedures / Professional Services finished fourth in total Medicaid spending among South Bend categories for 2024.
Statewide in Indiana, Procedures / Professional Services held the fifth spot for total Medicaid expenditures in 2024.
Over the five years through 2024, Medicaid payments associated with Procedures / Professional Services in South Bend climbed by $1,865,911—a 5964.7% surge. Some years, such as 2023 and 2021, posted especially sharp annual increases.
Spending in this category across South Bend appeared citywide, but most payments coupled with the Procedures / Professional Services category were highly concentrated in just a few ZIP codes. For 2024, ZIP codes 46619, 46601 and 46615 reported Medicaid payment totals for this category of $1,875,189, $18,628 and $1,462, respectively. Those 3 ZIP codes accounted for 99.9% of all Medicaid costs tied to this category in South Bend for the year.
Medicaid activity within this category also focused on several individual billing codes more heavily than others.
Between 2024 and 2023, the Procedures / Professional Services spend for South Bend Medicaid climbed 53.6%. Across all claim categories in the city over the same period, spending rose by 30.3%.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023, making up about 18% of overall U.S. health spending. This climbed dramatically from an estimated $613.5 billion in 2019—prior to the COVID-19 pandemic.
This rise equates to near 40% growth over several years, much of it driven by increased enrollment and service use both during and after the pandemic period.
Recent federal budget actions during the Trump administration have brought significant proposals to scale back federal Medicaid funding and alter the overall design of the program. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid spending by over $1 trillion over the coming decade. This law introduces new policies—including work requirements and greater cost-sharing—which could restrict coverage or decrease funding for certain recipients. The changes are projected to increase the financial responsibility on states, holding down federal expenditures even as Medicaid remains a primary source of health coverage for millions of people nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $31,282 | -45.4% |
| 2021 | $39,562 | 26.5% |
| 2022 | $42,558 | 7.6% |
| 2023 | $1,235,089 | 2802.1% |
| 2024 | $1,897,194 | 53.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $50,254,898 | 64.5% |
| 2 | Evaluation and Management | $14,163,401 | 18.2% |
| 3 | Ambulance and Other Transport Services and Supplies | $2,178,936 | 2.8% |
| 4 | Procedures / Professional Services | $1,897,194 | 2.4% |
| 5 | Durable Medical Equipment | $1,430,585 | 1.8% |
| 6 | Temporary National Codes (Non-Medicare) | $1,380,578 | 1.8% |
| 7 | Dental Services | $1,233,681 | 1.6% |
| 8 | Pathology and Laboratory Procedures | $937,101 | 1.2% |
| 9 | Medical And Surgical Supplies | $672,976 | 0.9% |
| 10 | Enteral and Parenteral Therapy | $618,796 | 0.8% |
| 11 | Orthotic Procedures and services | $571,664 | 0.7% |
| 12 | Radiology Procedures | $511,092 | 0.7% |
| 13 | Surgery | $501,512 | 0.6% |
| 14 | Alcohol and Drug Abuse Treatment | $473,467 | 0.6% |
| 15 | Vision Services | $420,067 | 0.5% |
| 16 | National Codes Established for State Medicaid Agencies | $401,008 | 0.5% |
| 17 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $178,839 | 0.2% |
| 18 | Chemotherapy Drugs | $22,764 | <0.1% |
| 19 | Temporary Codes | $6,990 | <0.1% |
| 20 | Anesthesia | $4,114 | <0.1% |
| 21 | Pathology and Laboratory Services | $3,623 | <0.1% |
| 22 | Drugs Administered Other than Oral Method | $2,028 | <0.1% |
| 23 | Prosthetic Procedures | $709 | <0.1% |
| 24 | Diagnostic Radiology Services | $347 | <0.1% |
| 25 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G2067 | Med assist tx meth wk | $1,832,322 | 28 |
| G2078 | Take-home meth | $40,193 | 23 |
| G0467 | Fqhc visit, estab pt | $19,290 | 35 |
| G0433 | Elisa hiv-1/hiv-2 screen | $2,673 | 7 |
| G0463 | Hospital outpt clinic visit | $1,785 | 2 |
| G0299 | Hhs/hospice of rn ea 15 min | $632 | 21 |
| G0155 | Hhcp-svs of csw,ea 15 min | $180 | 19 |
| G2211 | Complex e/m visit add on | $71 | 24 |
| G0307 | Cbc without platelet | $45 | 3 |
| G0008 | Admin influenza virus vac | $0 | 1 |
| G0156 | Hhcp-svs of aide,ea 15 min | $0 | 20 |
| G0300 | Hhs/hospice of lpn ea 15 min | $0 | 10 |
| G8785 | Bp scrn no perf at interval | $0 | 4 |
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.
