Portland Medicaid spending on Procedures / Professional Services rises to $27.9M in 2024

In 2024, Medicaid providers in Portland billed $27,883,525 for services categorized under Procedures / Professional Services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 38.7% rise from 2023, when providers billed $20,103,244 for comparable services.

Medicaid is a public health insurance program managed by individual states and funded through both federal and state governments. The program covers low-income individuals, families, children, seniors, and people with disabilities, ranking among the largest components of the U.S. health care system.

Because taxpayer dollars fund Medicaid payments, shifts in local billing amounts reveal how public health funding is distributed within a community.

The “Procedures / Professional Services” category encompasses services billed to Medicaid based on standardized HCPCS and CPT code groups reflecting the type of care. For this report, each billing code was assigned to one service category using standardized code prefixes and numeric groupings, which allows similar services to be tracked collectively without duplication and assures accuracy when analyzing trends over time.

Though Medicaid spending grew across various service categories, Procedures / Professional Services ranked third overall in terms of total Medicaid payments in Portland during 2024.

Statewide in Maine, Procedures / Professional Services held the fourth position by total Medicaid payments in 2024.

Between 2020 and 2024, Medicaid payments in Portland for the Procedures / Professional Services category rose by $11,754,474, or 72.9%. Periods of accelerated growth included 2023 and 2021, both showing substantial year-on-year increases.

While funding for Procedures / Professional Services was disbursed throughout Portland, the bulk was concentrated in certain ZIP codes. In 2024, ZIP codes 04102, 04103, and 04101 received $21,177,653, $6,371,397, and $334,474 respectively for these services, with the top 3 ZIP codes making up 100% of the city’s Medicaid spending for this category.

A small group of individual billing codes accounted for most Medicaid payments in the Procedures / Professional Services category.

When comparing the 38.7% rise in Procedures / Professional Services Medicaid payments from 2023 to 2024, the increase outpaced the city’s overall Medicaid payment growth across all categories, which stood at 9.3% for the same period.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures reached about $871.7 billion in fiscal year 2023, representing nearly 18% of total national health spending, a significant jump from approximately $613.5 billion in 2019—the year before the COVID-19 pandemic.

This growth marks an increase of about 40% over several years, largely attributed to rising enrollment and utilization during and after the pandemic.

Recent legislative changes under the Trump administration include major proposals to decrease federal Medicaid funding and alter the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to reduce federal Medicaid funding by over $1 trillion over the next decade. It introduces measures such as work requirements and higher cost-sharing, which could limit coverage and lower funding for some recipients. These policy shifts are expected to place more financial responsibility on states and limit federal support, amid ongoing demand for Medicaid services.

Note: HCPCS codes are provided for context within the category. All category overall totals and rankings in this article are based on standardized service groupings, not individual billing codes.

All information in this article is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the source data here.