Pathology and laboratory Medicaid payments rise 288.3% in Hico, reaching $1,029 in 2024

In 2024, Medicaid providers in Hico billed $1,029 for services under the Pathology and Laboratory Procedures category, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects a 288.3% rise from 2023, when $265 in claims were submitted for the same services.

Medicaid is managed at the state level with joint state and federal funding, and provides coverage to low-income families, children, seniors, and people with disabilities, making it a major component of the U.S. health care landscape.

Shifts in Medicaid billing directly reflect how taxpayer-funded health care resources are allocated within individual communities.

The Pathology and Laboratory Procedures category includes a collection of Medicaid-billed services categorized by care type, based on standard HCPCS and CPT codes. In this report, service codes were allocated to one category using established code ranges and prefixes, ensuring clarity in grouping similar services, eliminating double counting, and maintaining ranking accuracy over time.

Spending rose for several Medicaid service categories, with Pathology and Laboratory Procedures ranking third in Hico by total Medicaid payments in 2024.

On a statewide scale in West Virginia, Pathology and Laboratory Procedures ranked fifth by total Medicaid payments for 2024.

Reviewing the five years up to 2024, Hico saw Medicaid payments for Pathology and Laboratory Procedures increase by $1,029, with consistent amounts reported over that span. Some years, including 2023 and 2022, recorded considerable year-over-year jumps in spending.

Across Hico, most Medicaid spending for the Pathology and Laboratory Procedures category concentrated within a few ZIP codes. In 2024, ZIP code 25854 accounted for $1,028, which represented 100% of such Medicaid payments locally during the year.

Medicaid reimbursement within the Pathology and Laboratory Procedures category was focused on a small number of billing codes.

From 2023 to 2024 in Hico, Medicaid payments linked to the Pathology and Laboratory Procedures category increased by 288.3%, compared with a broader 8.9% increase across all Medicaid claim categories citywide in the same time frame.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid outlays totaled approximately $871.7 billion in fiscal year 2023. This represented about 18% of national health spending and an increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This change equates to about a 40% rise over several years, largely fueled by greater enrollment and utilization in the pandemic and post-pandemic periods.

Recent federal budget actions during the Trump administration have introduced major proposals to cut federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” passed in 2025, is set to reduce federal Medicaid spending by over $1 trillion over 10 years and includes new requirements such as work mandates and greater cost-sharing, likely decreasing coverage and funding for some participants. These measures are expected to shift additional costs to state governments and restrain federal Medicaid spending, even as millions still rely on the program.

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.