Medicaid payments for medicine services and procedures in Johnstown reach $20,463,202 in 2024

In 2024, Johnstown Medicaid providers submitted $20,463,202 in claims for services identified under the Medicine Services and Procedures category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflected a 0.7% rise over 2023, when $20,314,131 was billed for the same services.

Medicaid, a health insurance program for the public, is administered by states and jointly financed by state and federal governments. It supports low-income individuals and families, seniors, children, and people with disabilities, making it one of the main pillars of the U.S. health care system.

With taxpayer funding, local shifts in Medicaid billing shed light on how health care dollars are distributed throughout the community.

The Medicine Services and Procedures category consists of a range of Medicaid-billed services defined by the care provided, determined by standard HCPCS and CPT code groups. Each code was assigned to a specific service category with consistent code prefixes and ranges, keeping service groupings distinct and ensuring accurate year-over-year rankings without double counting.

While Medicaid spending rose in several categories, Medicine Services and Procedures ranked as the second-largest category in Johnstown for total Medicaid payments in 2024.

Statewide in Pennsylvania, Medicine Services and Procedures was third among all categories for Medicaid payments in 2024.

Between 2019 and 2024, the Medicine Services and Procedures category in Johnstown saw Medicaid payments grow by $18,880,649, or 1193.1%. Growth in spending accelerated at times, most notably in both 2021 and 2020.

Although payments in the Medicine Services and Procedures category were dispersed citywide, the majority of Medicaid spending came from just a few ZIP codes. In 2024, the highest Medicaid payments were in ZIP code 15901 at $15,490,329, followed by 15904 with $4,662,017, and 15905 at $310,709. Collectively, these 3 ZIP codes made up 100% of Johnstown’s Medicaid payments in this category during 2024.

Only a small group of billing codes within Medicine Services and Procedures accounted for most of the Medicaid payments.

When comparing 2024 to 2023, Johnstown’s Medicaid payments for Medicine Services and Procedures rose by 0.7%, while total Medicaid spending across all categories in the city increased by 2.3% for the same timeframe.

The Centers for Medicare & Medicaid Services reports federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023, representing about 18% of total national health costs. This is up from $613.5 billion in 2019, preceding the COVID-19 pandemic.

This change marks an increase of around 40% in just a few years, largely due to greater enrollment and heightened health service use during and after the pandemic period.

Recent federal budget measures under the Trump administration have featured significant plans to decrease federal Medicaid funding and reshape the program. For instance, the “One Big Beautiful Bill Act,” passed into law in 2025, is set to reduce federal Medicaid spending by more than $1 trillion over the next decade, instituting changes like work stipulations and increased cost-sharing that may decrease both funding and coverage for certain recipients. These revisions are expected to shift costs to states and restrict federal Medicaid funding growth, even while the program remains a source of coverage for tens of 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.