In 2024, Medicaid providers in Lexington billed a total of $13,683,272 for services falling under the Alcohol and Drug Abuse Treatment category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure reflects an increase of 100.1% from 2023, when billings for the same service type reached $6,837,690.
Medicaid, funded in tandem by federal and state governments, is a statewide public health insurance system supporting low-income people, families, seniors, children, and those with disabilities. Its wide reach makes it among the nation’s largest health care payers.
As Medicaid dollars are publicly sourced, fluctuations in community billing volumes demonstrate where health funding is used locally.
The “Alcohol and Drug Abuse Treatment” designation includes a group of services coded by standardized HCPCS and CPT assignments. For this analysis, billing codes were organized into a single service situation using shared prefixes and numeric intervals. This grouping enables tracking similar services without duplicate counting and helps maintain proper category ranking over time.
While Medicaid disbursements rose across multiple health service targets, Alcohol and Drug Abuse Treatment was the top Medicaid payment category in Lexington during 2024.
Across North Carolina overall, Alcohol and Drug Abuse Treatment ranked as the fourth largest Medicaid payment category statewide for 2024.
During the five years ending in 2024, Medicaid payments for Alcohol and Drug Abuse Treatment in Lexington rose by $11,012,193, a total increase of 412.3%. Growth rates were most pronounced in specific years, with significant jumps in both 2021 and 2022.
Though services under Alcohol and Drug Abuse Treatment were billed in locations across Lexington, the majority of Medicaid spending was focused in just two ZIP codes. In 2024, ZIP code 27295 accounted for $11,336,341 and ZIP code 27292 for $2,346,930, together representing 100% of local Medicaid spending for this service category.
Payments within the Alcohol and Drug Abuse Treatment classification were also concentrated in a relatively small set of individual billing codes.
Over the same period, Medicaid payments for Alcohol and Drug Abuse Treatment in Lexington grew by 100.1% between 2024 and 2023, compared to a 43.2% rise for all Medicaid claim categories locally.
According to the Centers for Medicare & Medicaid Services, total Medicaid spending by federal and state governments was about $871.7 billion in fiscal year 2023. That sum comprised nearly 18% of all national health spending, a substantial increase over the $613.5 billion tallied in 2019 just prior to the COVID-19 pandemic.
This equates to nearly 40% growth in a few years, largely attributed to greater enrollment and heightened utilization amid and following the pandemic years.
Recent budgets under the Trump administration have contained proposals seeking major reductions to federal Medicaid support and suggested substantial restructure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to slash more than $1 trillion from federal Medicaid spending over the next ten years and initiate provisions like work requirements and higher cost-sharing, which could reduce coverage and federal funding for some. These shifts may increase responsibilities for state budgets and cap federal Medicaid support, even while the program continues to insure tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $2,671,079 | 19.7% |
| 2021 | $3,754,932 | 40.6% |
| 2022 | $5,129,965 | 36.6% |
| 2023 | $6,837,690 | 33.3% |
| 2024 | $13,683,271 | 100.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $13,683,271 | 38.9% |
| 2 | Evaluation and Management | $6,918,079 | 19.7% |
| 3 | Medicine Services and Procedures | $5,911,188 | 16.8% |
| 4 | National Codes Established for State Medicaid Agencies | $4,109,692 | 11.7% |
| 5 | Temporary National Codes (Non-Medicare) | $2,484,224 | 7.1% |
| 6 | Ambulance and Other Transport Services and Supplies | $560,064 | 1.6% |
| 7 | Pathology and Laboratory Procedures | $473,645 | 1.3% |
| 8 | Radiology Procedures | $228,425 | 0.7% |
| 9 | Durable Medical Equipment | $227,970 | 0.6% |
| 10 | Dental Services | $206,171 | 0.6% |
| 11 | Medical And Surgical Supplies | $137,944 | 0.4% |
| 12 | Procedures / Professional Services | $83,485 | 0.2% |
| 13 | Drugs Administered Other than Oral Method | $37,016 | 0.1% |
| 14 | Surgery | $34,290 | 0.1% |
| 15 | Temporary Codes | $23,170 | 0.1% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $9,836 | <0.1% |
| 17 | Enteral and Parenteral Therapy | $1,829 | <0.1% |
| 18 | Administrative, Miscellaneous and Investigational | $1,127 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H0020 | Alcohol and/or drug services | $11,336,341 | 12 |
| H0040 | Assert comm tx pgm per diem | $1,920,329 | 12 |
| H2017 | Psysoc rehab svc, per 15 min | $234,261 | 12 |
| H0036 | Comm psy face-face per 15min | $93,099 | 18 |
| H0015 | Alcohol and/or drug services | $81,673 | 4 |
| H2011 | Crisis interven svc, 15 min | $12,933 | 2 |
| H0038 | Self-help/peer svc per 15min | $4,633 | 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.
