West Milford Medicaid payments for Pathology and Laboratory Procedures total $1,129 in 2024

In 2024, Medicaid providers in West Milford billed $1,129 for services in the Pathology and Laboratory Procedures category, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount is a 58.6% increase from 2023, when claims for the same category totaled $712.

Medicaid is a state-administered public health insurance program funded jointly by state and federal governments. The program provides coverage for low-income individuals and families, children, seniors, and people with disabilities, making it a major component of the nation’s health care system.

Since Medicaid is funded by taxpayers, changes in the volume of local billing reflect how community health care resources are distributed.

The “Pathology and Laboratory Procedures” grouping covers services billed to Medicaid and is based on standardized HCPCS and CPT code sets. This analysis assigned each billing code to a single category by code prefix and numeric range, allowing for the comparison of related care types, accurate ranking, and the avoidance of duplicate counting.

Medicaid spending increased in several service groups, and for 2024, Pathology and Laboratory Procedures was the second-highest category by total Medicaid payment in West Milford.

Statewide, West Virginia ranked Pathology and Laboratory Procedures as the fifth-largest Medicaid spending category in 2024.

Between 2019 and 2024, Medicaid payments for Pathology and Laboratory Procedures in West Milford grew by $654, or 137.6%. Specific periods, including 2021 and 2022, saw especially strong year-over-year increases in local spending.

Though service costs were paid across various areas of the city, most Medicaid payments for Pathology and Laboratory Procedures in 2024 were attributed to a small set of ZIP codes. During the same year, the 26451 ZIP code contributed $1,129 in Medicaid payments for this category, accounting for 100% of the city’s Medicaid spending in Pathology and Laboratory Procedures.

Payments within this category were also focused on a small number of individual billing codes.

When compared to a 14.8% increase across all Medicaid claim types in the city from 2023 to 2024, Pathology and Laboratory Procedures spending grew by 58.6% over the same period in West Milford.

The Centers for Medicare & Medicaid Services report that nationwide Medicaid spending reached roughly $871.7 billion in fiscal year 2023, representing approximately 18% of the country’s total health care expenditures, up notably from $613.5 billion in 2019 prior to the COVID-19 pandemic.

This surge reflects an increase of around 40% within several years, largely attributed to more widespread enrollment and greater use of services during and after the pandemic.

Recent federal budget actions taken under the Trump administration have included major proposals to trim federal Medicaid funding and overhaul the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, plans to reduce federal Medicaid funding by over $1 trillion over the coming decade and introduces measures like work requirements and increased cost-sharing, which could result in reduced coverage and funding for some beneficiaries. These measures are projected to shift greater financial burden to states and limit growth in federal Medicaid support, while the program remains responsible for providing coverage to millions of Americans.

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.