Clifton Medicaid spending on Medicine Services and Procedures climbs 3.4% in 2024

In 2024, providers in Clifton submitted $10,657,954 in Medicaid claims for services classified as Medicine Services and Procedures, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was an increase of 3.4% from 2023, when $10,305,572 was billed for the same service category.

Medicaid operates as a public insurance program, managed at the state level and financed through a combination of federal and state funds. It covers eligible low-income families, seniors, children, and people with disabilities, and remains a significant part of the nation’s health care safety net.

Since Medicaid payments originate from taxpayer dollars, shifts in local billing offer insight into how public health care resources are distributed within communities.

The “Medicine Services and Procedures” category encompasses a range of services that are grouped based on the type of care delivered and standardized by HCPCS and CPT code ranges. For this reporting, each billing code was sorted into one service group according to specific code prefixes and numbers, enabling analysis across related services without overlapping counts or distorting ranking trends.

Across various service categories, Medicaid expenses increased, but Medicine Services and Procedures was ranked as the fourth-largest by total payment amount in Clifton during 2024.

Statewide in New Jersey, Medicine Services and Procedures also held the fourth spot for Medicaid payments in 2024.

Between 2019 and 2024, Clifton’s Medicaid payments in the Medicine Services and Procedures category increased by $5,994,008, marking growth of 128.5%. Periods of sharper annual increases, notably in 2022 and 2023, contributed to this escalation.

Although spending in this category was spread throughout Clifton, most Medicaid payments were concentrated among a handful of ZIP codes. In 2024, ZIP code 07011 accounted for $6,991,073, 07013 for $3,312,356 and 07012 for $354,524, comprising 100% of the city’s Medicaid payments in this service class for the year.

Payment distribution within the Medicine Services and Procedures category was also clustered around relatively few billing codes.

Medicaid payments for Medicine Services and Procedures in Clifton increased by 3.4% from 2023 to 2024. By contrast, payments spanning all Medicaid claim categories in the city rose by 5.4% during the same interval.

The Centers for Medicare & Medicaid Services reports that combined federal and state Medicaid spending amounted to about $871.7 billion in fiscal year 2023. That represented roughly 18% of total national health costs, surging from about $613.5 billion in 2019, before the COVID-19 pandemic.

This approximately 40% increase over just a few years was largely fueled by expanded eligibility and rising utilization during and after the pandemic.

Recent congressional budget action under the Trump administration included proposals to trim federal Medicaid allocations and overhaul the program’s structure. Notably, the “One Big Beautiful Bill Act,” signed in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over a decade. It also introduces measures such as work requirements and added cost-sharing, projected to curb coverage and reduce funding for some recipients. These changes are anticipated to increase pressure on state budgets and limit federal growth for Medicaid, even though the program continues to support tens of millions nationwide.

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.