In 2024, Medicaid providers in Vernon billed a total of $36,344 for Pathology and Laboratory Procedures services, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This figure represents a 7% uptick from 2023, when $33,961 in claims for the same services were submitted.
Medicaid, a public health insurance program administered by the states and funded by both federal and state governments, provides coverage for low-income individuals and families, seniors, children, and people with disabilities. It is one of the largest components of the U.S. health care system.
Since Medicaid payments come from public funds, shifts in the amount billed locally indicate how community health care resources are distributed.
The “Pathology and Laboratory Procedures” classification groups together Medicaid-billed services according to the care type, as determined by standardized HCPCS and CPT code clusters. For this analysis, each code was assigned exclusively to a single service group based on code prefixes and numbering, helping ensure related services were analyzed together without double counting and maintaining ranking integrity over time.
Spending grew across several Medicaid categories, but Pathology and Laboratory Procedures was the fourth largest by total Medicaid payments in Vernon for 2024.
Statewide in Texas, Pathology and Laboratory Procedures ranked sixth by total Medicaid payments in 2024.
Looking at the five years prior to 2024, Medicaid payments for Pathology and Laboratory Procedures in Vernon grew by $29,095, equivalent to a 401.4% increase. Certain years, especially 2021 and 2022, saw particularly rapid annual growth.
Payments for services in the Pathology and Laboratory Procedures category were spread throughout Vernon, but most funds went to a limited number of ZIP codes. The highest Medicaid payments in 2024 tied to this category went to ZIP code 76384, which accounted for the full $36,344. Altogether, the top ZIP code represented 100% of the city’s Medicaid spending in this category for the year.
Within Pathology and Laboratory Procedures, the majority of Medicaid payments were concentrated in a few specific billing codes.
Between 2024 and 2023, Medicaid payments for Pathology and Laboratory Procedures in Vernon rose by 7%, whereas all Medicaid claim categories combined saw a 29.9% change in the city during the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal 2023, making up about 18% of total national health spending. This is a notable increase from the $613.5 billion spent in 2019 before the COVID-19 pandemic began.
The overall growth amounts to about 40% in just a few years, with expanded enrollment and higher usage during and after the pandemic driving the increase.
Recent federal budget measures enacted under the Trump administration have included major proposals aimed at reducing federal Medicaid funding and changing the program’s structure. For example, the “One Big Beautiful Bill Act,” approved in 2025, is expected to cut more than $1 trillion from federal Medicaid spending over the next 10 years and introduces changes such as work requirements and increased cost-sharing, which could reduce coverage and funding for some participants. These modifications are anticipated to require states to absorb more costs and slow the growth of federal Medicaid aid, even as the program continues to provide for tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $7,249 | – |
| 2021 | $49,897 | 588.3% |
| 2022 | $53,956 | 8.1% |
| 2023 | $33,961 | -37.1% |
| 2024 | $36,344 | 7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $447,857 | 65.7% |
| 2 | Evaluation and Management | $120,930 | 17.7% |
| 3 | Dental Services | $72,907 | 10.7% |
| 4 | Pathology and Laboratory Procedures | $36,344 | 5.3% |
| 5 | Durable Medical Equipment | $3,245 | 0.5% |
| 6 | Medicine Services and Procedures | $298 | <0.1% |
| 7 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 7 | Medical And Surgical Supplies | $0 | <0.1% |
| 7 | Procedures / Professional Services | $0 | <0.1% |
| 7 | Surgery | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 87502 | Influenza dna amp probe | $16,000 | 10 |
| 87635 | Sars-cov-2 covid-19 amp prb | $8,262 | 10 |
| 87651 | Strep a dna amp probe | $5,881 | 10 |
| 87636 | Sarscov2 & inf a&b amp prb | $4,233 | 2 |
| 87634 | Rsv dna/rna amp probe | $1,210 | 1 |
| 87880 | Strep a assay w/optic | $282 | 2 |
| 85025 | Complete cbc w/auto diff wbc | $138 | 11 |
| 80053 | Comprehen metabolic panel | $134 | 11 |
| 84443 | Assay thyroid stim hormone | $69 | 5 |
| 83036 | Hemoglobin glycosylated a1c | $53 | 8 |
| 87086 | Urine culture/colony count | $44 | 9 |
| 81001 | Urinalysis auto w/scope | $30 | 10 |
| 80061 | Lipid panel | $5 | 3 |
| 80048 | Basic metabolic pnl total ca | $0 | 1 |
| 87088 | Urine bacteria culture | $0 | 2 |
| 87186 | Sc std microdil/agar dil | $0 | 3 |
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.
