Prescott Medicaid providers charged $220,068 for Pathology and Laboratory Procedures in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 3.6% rise over 2023, when claims for this category amounted to $212,361.
Medicaid is a state-run health insurance program funded concertedly by the federal and state governments. It serves low-income people and families, seniors, children and those with disabilities, and is a key component of U.S. health care.
Since taxpayer dollars fund Medicaid, changes in billing reflect how public health funding is distributed within a community.
The “Pathology and Laboratory Procedures” classification encompasses a selection of Medicaid-billed services organized by type of care, determined through standard HCPCS and CPT codes. For this assessment, each billing code was mapped to a service category via code prefixes and number ranges, supporting aggregated analysis, accurate ranking, and the avoidance of duplicate counting.
Medicaid spending increased across a range of services, but Pathology and Laboratory Procedures was ranked 10th in total Medicaid payments in Prescott for 2024.
Statewide in Arizona, Pathology and Laboratory Procedures ranked eighth for total Medicaid payments in 2024.
Looking over the five years leading to 2024, Prescott’s Medicaid payments for Pathology and Laboratory Procedures grew by $89,051, or 28.8%. Spending growth was particularly notable in certain years, such as 2021 and 2022.
While services in the Pathology and Laboratory Procedures category were distributed throughout Prescott, most payments were concentrated in specific ZIP codes. The highest amounts for 2024 were: 86301, with $183,339; 86303, totaling $30,996; and 86305, at $5,731. Combined, these 3 ZIP codes accounted for all Medicaid spending in this category in the city for the year.
Medicaid expenditures within this service category were focused on just a few individual billing codes.
For context, Pathology and Laboratory Procedures grew by 3.6% in Prescott between 2023 and 2024. By comparison, Medicaid payments across all categories in the area increased at a rate of 18.8% over the same time frame.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures totaled about $871.7 billion in fiscal year 2023, representing roughly 18% of all U.S. health care expenditures, up from $613.5 billion in 2019, which was before the COVID-19 pandemic.
This change represents an increase of around 40% over a few years, mainly propelled by higher enrollment and increased utilization due to and following the pandemic.
Recent federal budget laws under the Trump administration have included large-scale proposals for reducing federal Medicaid funding and altering program structure. As one example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut Medicaid funding by more than $1 trillion over a decade and implement requirements such as work standards and greater cost-sharing. This could limit coverage and resources for certain groups, shifting additional burden to states at a time when the program covers tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $309,118 | -23.4% |
| 2021 | $422,163 | 36.6% |
| 2022 | $283,185 | -32.9% |
| 2023 | $212,360 | -25% |
| 2024 | $220,067 | 3.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $12,210,901 | 35.5% |
| 2 | Evaluation and Management | $10,254,427 | 29.8% |
| 3 | National Codes Established for State Medicaid Agencies | $3,493,410 | 10.2% |
| 4 | Radiology Procedures | $2,685,489 | 7.8% |
| 5 | Ambulance and Other Transport Services and Supplies | $2,448,505 | 7.1% |
| 6 | Medicine Services and Procedures | $1,810,112 | 5.3% |
| 7 | Dental Services | $653,464 | 1.9% |
| 8 | Surgery | $255,280 | 0.7% |
| 9 | Temporary National Codes (Non-Medicare) | $222,279 | 0.6% |
| 10 | Pathology and Laboratory Procedures | $220,067 | 0.6% |
| 11 | Outpatient PPS | $30,265 | 0.1% |
| 12 | Durable Medical Equipment | $26,765 | 0.1% |
| 13 | Procedures / Professional Services | $23,185 | 0.1% |
| 14 | Drugs Administered Other than Oral Method | $16,712 | <0.1% |
| 15 | Orthotic Procedures and services | $8,962 | <0.1% |
| 16 | Diagnostic Radiology Services | $4,960 | <0.1% |
| 17 | Temporary Codes | $2,961 | <0.1% |
| 18 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 18 | Medical And Surgical Supplies | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 88305 | Tissue exam by pathologist | $94,111 | 61 |
| 82075 | Assay of breath ethanol | $30,996 | 5 |
| 80307 | Drug test prsmv chem anlyzr | $27,004 | 32 |
| 80053 | Comprehen metabolic panel | $19,945 | 14 |
| 88342 | Imhchem/imcytchm 1st antb | $12,124 | 25 |
| 83036 | Hemoglobin glycosylated a1c | $3,489 | 45 |
| 80061 | Lipid panel | $2,984 | 26 |
| 80305 | Drug test prsmv dir opt obs | $2,869 | 25 |
| 80050 | General health panel | $2,796 | 7 |
| 86900 | Blood typing serologic abo | $2,664 | 12 |
| 88307 | Tissue exam by pathologist | $2,157 | 1 |
| 87651 | Strep a dna amp probe | $1,852 | 12 |
| 87635 | Sars-cov-2 covid-19 amp prb | $1,651 | 12 |
| 88341 | Imhchem/imcytchm ea add antb | $1,590 | 2 |
| 87804 | Influenza assay w/optic | $1,563 | 8 |
| 81025 | Urine pregnancy test | $1,489 | 12 |
| 85025 | Complete cbc w/auto diff wbc | $1,395 | 17 |
| 84443 | Assay thyroid stim hormone | $1,295 | 12 |
| 87640 | Staph a dna amp probe | $1,190 | 3 |
| 86580 | Tb intradermal test | $1,036 | 6 |
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.
