In 2024, Medicaid providers in Auburn billed a total of $339,574 for services under the Pathology and Laboratory Procedures category, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 52.8% rise from 2023, when $222,206 in claims were filed for similar services.
Medicaid is a public health insurance initiative managed by individual states and funded collectively with federal and state resources. The program provides coverage to low-income residents, children, older adults, and individuals with disabilities, making it one of the key components of the U.S. health system.
Since Medicaid is taxpayer-funded, changes in billing at the local level indicate how public health funding moves within a specific community.
The “Pathology and Laboratory Procedures” category represents a combined set of Medicaid-billed services defined by care type, using standardized HCPCS and CPT code pools. This analysis grouped each billing code exclusively within one service area based on consistent code prefixes and numbers, ensuring similar services were reviewed together while preventing data overlap and keeping rankings consistent across years.
Despite expanded Medicaid spending in several service categories, Pathology and Laboratory Procedures was the fifth largest category by total Medicaid payments in Auburn for 2024.
On a statewide basis, Pathology and Laboratory Procedures placed third in Alabama by total Medicaid payments in 2024.
In the five years prior to 2024, Auburn’s Medicaid payments tied to Pathology and Laboratory Procedures grew by $297,555, amounting to a 708.2% surge. There were periods of rapid growth, including significant annual gains in both 2021 and 2023.
Medicaid spending on Pathology and Laboratory Procedures, though available throughout the city, was especially concentrated in a few ZIP codes. ZIP code 36830 accounted for $283,180, while ZIP code 36832 made up $56,393, combining to represent 100% of Auburn’s Medicaid payments in this category in 2024.
Spending was also focused on a select group of individual billing codes inside the Pathology and Laboratory Procedures group.
For context, Medicaid payments tied to the Pathology and Laboratory Procedures category in Auburn increased 52.8% between 2024 and 2023, while citywide Medicaid claim payments increased by 19.2% for all categories in the same timeframe.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending was roughly $871.7 billion for fiscal 2023. That was about 18% of the country’s total health care costs and represents a notable climb from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This reflects a nearly 40% increase in just a few years, attributed mainly to expanded participation and higher service use in the pandemic’s aftermath.
Recent federal budget measures under the Trump administration have suggested considerable reductions to federal Medicaid funding and efforts to restructure the program. One example, the “One Big Beautiful Bill Act,” which became law in 2025, is forecast to reduce federal Medicaid spending by over $1 trillion in the coming decade while implementing work requirements and greater cost-sharing that may cut back funding and coverage for certain groups. These policy adjustments are likely to increase state responsibilities for costs and restrict the growth of federal support for Medicaid, even as the coverage continues to reach tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $42,018 | -2.9% |
| 2021 | $137,821 | 228% |
| 2022 | $134,258 | -2.6% |
| 2023 | $222,205 | 65.5% |
| 2024 | $339,573 | 52.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $1,305,090 | 27.8% |
| 2 | Evaluation and Management | $919,791 | 19.6% |
| 3 | Dental Services | $840,287 | 17.9% |
| 4 | Medical And Surgical Supplies | $745,313 | 15.9% |
| 5 | Pathology and Laboratory Procedures | $339,573 | 7.2% |
| 6 | Durable Medical Equipment | $250,118 | 5.3% |
| 7 | National Codes Established for State Medicaid Agencies | $243,933 | 5.2% |
| 8 | Vision Services | $32,775 | 0.7% |
| 9 | Surgery | $5,961 | 0.1% |
| 10 | Enteral and Parenteral Therapy | $5,003 | 0.1% |
| 11 | Procedures / Professional Services | $2,075 | <0.1% |
| 12 | Temporary National Codes (Non-Medicare) | $680 | <0.1% |
| 13 | Radiology Procedures | $538 | <0.1% |
| 14 | Drugs Administered Other than Oral Method | $38 | <0.1% |
| 15 | Prosthetic Procedures | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 87811 | Sars-cov-2 covid19 w/optic | $123,332 | 135 |
| 87804 | Influenza assay w/optic | $94,065 | 128 |
| 87633 | Resp virus 12-25 targets | $56,279 | 14 |
| 87880 | Strep a assay w/optic | $47,934 | 124 |
| 87428 | Sarscov & inf vir a&b ag ia | $9,302 | 10 |
| 87430 | Strep a ag ia | $4,799 | 16 |
| 87807 | Rsv assay w/optic | $2,807 | 23 |
| 81003 | Urinalysis auto w/o scope | $503 | 22 |
| 86308 | Heterophile antibody screen | $242 | 7 |
| 85025 | Complete cbc w/auto diff wbc | $137 | 1 |
| 81025 | Urine pregnancy test | $117 | 6 |
| 80305 | Drug test prsmv dir opt obs | $52 | 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.