Vergennes Medicaid costs for medicine services and procedures reach $18,310 in 2024

In 2024, Medicaid providers in Vergennes submitted $18,310 in claims for services grouped under the Medicine Services and Procedures category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. That amount marked a 52.4% increase compared with 2023, when claims for the same grouping totaled $12,018.

Medicaid, funded jointly by states and the federal government, is a public health insurance program. It covers people with low incomes, seniors, children and individuals with disabilities, making it a major component of the U.S. health care system.

Because taxpayer dollars fund Medicaid, shifts in local billing illustrate how public health funding is distributed within communities.

The “Medicine Services and Procedures” category includes a set of Medicaid-billed services identified by the type of care, grouped using specific HCPCS and CPT code prefixes and numeric ranges. For these figures, each billing code was assigned a single category, preventing duplication and providing consistency for comparing related services year over year.

While Medicaid spending rose across several groups, Medicine Services and Procedures ranked as the second-largest category for total Medicaid payments within Vergennes during 2024.

Statewide, the Medicine Services and Procedures category was the fifth-largest category by Medicaid payments in Vermont in 2024.

In the five years leading up to 2024, Medicaid payments associated with Medicine Services and Procedures in Vergennes grew by $12,291, or 204.2%. The pace of growth accelerated in select periods, with notable gains logged in 2021 and 2023.

Spending in this category was distributed citywide but concentrated in few ZIP codes. In 2024, ZIP code 05491 accounted for the full $18,310 in Medicaid payments in this category. Combined, the top 1 ZIP code was responsible for 100% of all Medicaid payments for Medicine Services and Procedures in Vergennes during the year.

Within the Medicine Services and Procedures group, payments were focused on a small set of individual billing codes.

For context, between 2024 and 2023, Medicaid payments in the Medicine Services and Procedures category in Vergennes increased 52.4%, while the total for all Medicaid claim categories in the city rose 21.9% for the period.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid payments reached roughly $871.7 billion in fiscal year 2023, representing about 18% of national health expenditures. That is up substantially from approximately $613.5 billion in 2019, before the COVID-19 pandemic.

This increase equates to about 40% growth over several years, with expanded enrollment and greater utilization credited as primary factors during the pandemic and its aftermath.

Recent federal budget initiatives passed under the Trump administration brought forth major proposals that decrease federal Medicaid dollars and reshape policy. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut more than $1 trillion in federal Medicaid spending over 10 years, adding elements like work requirements and higher cost-sharing that could decrease access and funding for some beneficiaries. These policy changes are projected to place more financial responsibility on states and limit the growth of federal Medicaid resources while millions continue to rely on the program.

Note: HCPCS codes are provided for category context. Category totals and rankings here rely on organized service groups, not individual billing codes.

Information for this article is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Source data are available here.