In 2024, Medicaid providers in Idaho Falls billed a total of $2,857,193 for services in the Procedures / Professional Services category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure reflects an increase of 21.9% from 2023, when $2,343,126 was billed for comparable services.
Medicaid, which is jointly financed by federal and state governments and managed by the states, serves low-income families and individuals, seniors, children, and those with disabilities. The program is one of the largest elements of the nation’s health system.
Since Medicaid’s funding comes from taxpayers, local billing amounts reflect how public health care funds are distributed across a region.
The Procedures / Professional Services category includes a range of Medicaid-billed services classified by the type of care, using defined HCPCS and CPT code sets. For this report, each billing code was assigned to a distinct service category based on consistent code prefixes and ranges, allowing an apples-to-apples analysis while preventing overlap and ensuring accurate rankings through the years.
Spending on Procedures / Professional Services was one of several Medicaid categories to see increases, ranking fifth by dollar amount in Idaho Falls in 2024.
On a statewide basis, Procedures / Professional Services ranked sixth among Medicaid payment categories in Idaho in 2024.
During the five-year period ending in 2024, total Medicaid payments for Procedures / Professional Services in Idaho Falls climbed by $716,976, or 33.5%. Certain years, notably 2023 and 2022, saw the most significant year-over-year gains.
Spending was spread citywide yet most heavily centered in several ZIP codes. In 2024, ZIP code 83401 accounted for $2,468,047 in Medicaid payments within this category, followed by 83402 at $256,370 and 83404 at $132,775. These 3 ZIP codes together represented all Medicaid spending on Procedures / Professional Services reported for Idaho Falls that year.
Within this service category, a small set of billing codes received the majority of Medicaid payments.
Comparing 2024 with 2023, Medicaid spending on Procedures / Professional Services rose by 21.9% in Idaho Falls. Across all Medicaid claim categories in the city, the overall increase was 5.2% during the same period.
The Centers for Medicare & Medicaid Services reported that combined federal and state Medicaid outlays reached approximately $871.7 billion in fiscal year 2023, representing about 18% of total U.S. health expenditures. That amount is up from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This rise equates to about 40% growth over a few years, mainly due to increased enrollment and higher care usage during and after the pandemic.
Major federal budget proposals under the Trump administration have called for deep Medicaid reductions and structural shifts. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over a decade, introducing policies like work requirements and higher cost-sharing that may restrict coverage and funding for certain beneficiaries. These measures could place additional financial responsibility on states and curb federal Medicaid growth, even as the program covers tens of millions nationally.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $2,140,217 | -17.6% |
| 2021 | $1,529,577 | -28.5% |
| 2022 | $1,498,288 | -2% |
| 2023 | $2,343,125 | 56.4% |
| 2024 | $2,857,192 | 21.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $23,356,408 | 44.8% |
| 2 | Evaluation and Management | $6,911,403 | 13.3% |
| 3 | Medicine Services and Procedures | $6,349,881 | 12.2% |
| 4 | National Codes Established for State Medicaid Agencies | $5,322,649 | 10.2% |
| 5 | Procedures / Professional Services | $2,857,192 | 5.5% |
| 6 | Temporary National Codes (Non-Medicare) | $2,224,163 | 4.3% |
| 7 | Pathology and Laboratory Procedures | $1,439,403 | 2.8% |
| 8 | Dental Services | $747,642 | 1.4% |
| 9 | Radiology Procedures | $605,778 | 1.2% |
| 10 | Ambulance and Other Transport Services and Supplies | $594,464 | 1.1% |
| 11 | Durable Medical Equipment | $507,908 | 1% |
| 12 | Medical And Surgical Supplies | $417,743 | 0.8% |
| 13 | Surgery | $341,225 | 0.7% |
| 14 | Drugs Administered Other than Oral Method | $235,527 | 0.5% |
| 15 | Anesthesia | $159,819 | 0.3% |
| 16 | Temporary Codes | $29,195 | 0.1% |
| 17 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $7,714 | <0.1% |
| 18 | Orthotic Procedures and services | $3,964 | <0.1% |
| 19 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 19 | Vision Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G9002 | Mccd,maintenance rate | $2,134,303 | 54 |
| G9007 | Mccd, sch team conf | $604,693 | 33 |
| G2211 | Complex e/m visit add on | $63,416 | 107 |
| G0108 | Diab manage trn per indiv | $37,988 | 12 |
| G0463 | Hospital outpt clinic visit | $12,789 | 17 |
| G8510 | Scr dep neg, no plan reqd | $2,179 | 14 |
| G0467 | Fqhc visit, estab pt | $953 | 1 |
| G0283 | Elec stim other than wound | $868 | 3 |
| G0008 | Admin influenza virus vac | $0 | 2 |
| G0151 | Hhcp-serv of pt,ea 15 min | $0 | 20 |
| G0152 | Hhcp-serv of ot,ea 15 min | $0 | 5 |
| G0299 | Hhs/hospice of rn ea 15 min | $0 | 20 |
| G0300 | Hhs/hospice of lpn ea 15 min | $0 | 1 |
| G8783 | Bp scrn perf rec interval | $0 | 1 |
| G8785 | Bp scrn no perf at interval | $0 | 1 |
| G8950 | Pre-htn or htn doc, f/u indc | $0 | 1 |
| G8952 | Pre-htn/htn, no f/u, not gvn | $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.
