Medicaid spending for medicine services climbs 12% in Durham in 2024

Durham Medicaid providers billed $48,633,395 for Medicine Services and Procedures in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents an 11.8% rise from 2023, when providers claimed $43,500,267 under the same service type.

Medicaid, a public health insurance initiative managed by states and funded through both federal and state sources, insures individuals and families with low incomes, as well as seniors, children, and people with disabilities. It remains among the largest systems in U.S. health care.

Taxpayers fund Medicaid payments, so shifts in local billing highlight community-level allocation of public health spending.

The “Medicine Services and Procedures” segment includes various Medicaid-billed services grouped by care type, as defined by standardized HCPCS and CPT code designations. For this review, codes were allocated to one primary service group based on code prefixes and numeric range, letting related service billing be analyzed together without duplication or loss of ranking accuracy over time.

Though Medicaid expenditures increased in several service categories, Medicine Services and Procedures was second only to one other category by total Medicaid payments in Durham in 2024.

Statewide, Medicine Services and Procedures ranked third by Medicaid payments in North Carolina for 2024.

Durham’s Medicaid payments for Medicine Services and Procedures rose $23,151,960, or 90.9%, over the five years ending in 2024. Several periods saw especially strong growth, with major yearly jumps appearing in both 2023 and 2021.

Payments for care provided in the Medicine Services and Procedures category emerged in various areas of Durham, but a small number of ZIP codes received the majority. In 2024, ZIP code 27713 topped $20,948,110, followed by 27707 with $9,451,868, and 27704 reporting $5,195,390. Combined, these top 3 ZIP codes accounted for 73.2% of total Medicaid payments within this category citywide.

Within Medicine Services and Procedures, most Medicaid payments concentrated in a small subset of billing codes.

For reference, Durham saw an 11.8% year-over-year gain in Medicaid spending for Medicine Services and Procedures from 2023 to 2024. For all Medicaid claim types in the city, the comparable change was 8.8% over the period.

Data from the Centers for Medicare & Medicaid Services shows that combined state and federal Medicaid spending reached roughly $871.7 billion nationally in fiscal year 2023. That represented about 18% of total U.S. health care spending and was up dramatically from about $613.5 billion in 2019, just prior to the COVID-19 pandemic.

The gain marks growth of around 40% within a few years, most of which stemmed from higher enrollment and expanded service use during and after the pandemic period.

Recent Trump administration-led budget legislation has included notable measures to reduce Medicaid funding and reorganize the program on the federal level. The “One Big Beautiful Bill Act,” signed into law in 2025, is projected to reduce federal outlays for Medicaid by over $1 trillion over 10 years and includes new work requirements and higher cost-sharing expected to lower enrollment and spending for some patients. With these changes, federal Medicaid support growth is likely to slow, with more financial responsibility shifting to states while the program continues to cover 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.