Fulton Medicaid payments for pathology, lab services increase 21.6% in 2024

In 2024, Medicaid providers in Fulton billed a total of $1,436,948 for services categorized as Pathology and Laboratory Procedures, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 21.6% increase over 2023, when providers filed $1,181,383 in claims for these services.

Medicaid, a government public health insurance program administered by each state and jointly funded by federal and state governments, provides coverage to low-income families and individuals, seniors, children and people with disabilities. It is one of the most significant components of the U.S. health care system. More details about Medicaid funding are available from the Commonwealth Fund.

Since Medicaid payments are taxpayer-funded, shifts in local billing illustrate how community health care funds are distributed.

The “Pathology and Laboratory Procedures” designation comprises various Medicaid-billed services defined by type of care, which are organized based on standard HCPCS and CPT coding groups. In this analysis, each billing code falls into a single service category using consistent prefixes and number ranges, aligning related services for accuracy while avoiding duplication and maintaining valid time-based rankings.

Pathology and Laboratory Procedures was the third largest Medicaid service category in Fulton by total payments for 2024, while multiple categories saw elevated spending.

Statewide in Maryland, Pathology and Laboratory Procedures ranked sixth in terms of Medicaid outlays for 2024.

Comparing the five years ending in 2024, Medicaid spending associated with Pathology and Laboratory Procedures in Fulton rose by $1,370,239, a 2054.1% increase. Periods such as 2020 and 2023 featured accelerated year-over-year growth.

Although this service category’s spending spanned across Fulton, the majority of Medicaid payments were focused in a small number of ZIP codes. In 2024, ZIP code 20759 alone reported $1,436,948 in Medicaid payments for Pathology and Laboratory Procedures, constituting 100% of such payments within that year for Fulton.

Medicaid payments for Pathology and Laboratory Procedures were also highly concentrated among a select group of billing codes.

Between 2024 and 2023, Medicaid outlays for Pathology and Laboratory Procedures in Fulton rose 21.6%, while total Medicaid claim payments citywide across all categories shifted by 9.5% during the same timeframe.

Centers for Medicare & Medicaid Services data show that combined federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023, making up about 18% of the nation’s total health spending, a sharp increase from $613.5 billion in 2019, ahead of the COVID-19 pandemic.

That expansion amounts to an estimated 40% growth in a few years, attributed primarily to increased enrollment and greater demand during and after the pandemic.

Recent federal budget actions passed under the Trump administration featured major plans aimed at reducing the federal Medicaid share and modifying the program’s structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to decrease federal Medicaid allocations by over $1 trillion over 10 years and introduce measures such as work mandates and higher cost-sharing. These changes could decrease coverage and funding for some recipients, shift costs to states, and slow federal Medicaid growth, all while the program continues to aid 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.