Ashland Medicaid payments for pathology, lab services climb to $24,245 in 2024

Dr. Mehmet Oz CMS Administrator
Dr. Mehmet Oz CMS Administrator
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In 2024, Medicaid providers in Ashland received $24,245 for Pathology and Laboratory Procedures services, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. That total reflects a 25.5% rise from 2023, when $19,314 was billed under the same service category.

Medicaid, a joint state and federal health insurance program, is funded by both governments and covers low-income families and individuals, seniors, children, and people with disabilities. It represents a significant share of the U.S. health care sector.

Because Medicaid is taxpayer-funded, fluctuations in local billing reflect how community health care dollars are distributed.

The “Pathology and Laboratory Procedures” designation groups related Medicaid-billed services using standardized HCPCS and CPT code sets. For this report, each code was categorized within a single service type via consistent code ranges, supporting an unduplicated review and maintaining ranking accuracy over time.

Spending grew among several Medicaid service categories, with Pathology and Laboratory Procedures finishing second in Ashland for total Medicaid payments in 2024.

Statewide in Alabama, Pathology and Laboratory Procedures was the third-highest Medicaid spending category in 2024.

Looking at the five years before 2024, Medicaid payments for Pathology and Laboratory Procedures in Ashland increased by $19,019, or 364%. Payments rose especially sharply in certain years, notably in 2022 and 2021.

While such spending spanned different parts of the city, totals were concentrated in just a few ZIP codes. In 2024, the highest payments for Pathology and Laboratory Procedures were in ZIP code 36251, adding up to $24,244 and representing 100% of category payments in Ashland for the year.

Within this service area, Medicaid spending was focused on a relatively small selection of billing codes.

Comparatively, Medicaid spending for Pathology and Laboratory Procedures in Ashland grew by 25.5% between 2024 and 2023, compared to an overall 20.4% increase across all Medicaid categories in the city for the same period.

The Centers for Medicare & Medicaid Services report that federal and state Medicaid spending combined reached approximately $871.7 billion in fiscal year 2023, making up about 18% of national health expenditures—a sharp rise from around $613.5 billion in 2019, prior to the COVID-19 pandemic.

This increase marks nearly 40% growth in just a few years, primarily due to greater enrollment and utilization following the pandemic.

Recent federal budget measures during the Trump administration have included major proposals to reduce federal Medicaid outlays and modify the structure of the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to cut more than $1 trillion in federal Medicaid spending over the next 10 years. The law implements changes such as work requirements and higher cost-sharing, which may lower coverage and funding for some recipients. These reforms are forecast to shift more of the Medicaid funding burden to states and slow federal support growth, even as the program continues to serve millions nationwide.

Medicaid Payments Tied to Pathology and Laboratory Procedures in Ashland, Alabama Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $5,225 -47%
2021 $6,790 29.9%
2022 $16,768 146.9%
2023 $19,313 15.2%
2024 $24,244 25.5%
Top Categories by Medicaid Payments in Ashland, Alabama, 2024

Rank Category Medicaid Payments Share of City Total
1 Evaluation and Management $244,978 84.3%
2 Pathology and Laboratory Procedures $24,244 8.3%
3 Medicine Services and Procedures $21,505 7.4%
4 Drugs Administered Other than Oral Method $38 <0.1%
5 Surgery $0 <0.1%
Top 20 HCPCS Codes Within the Pathology and Laboratory Procedures Category in Ashland, Alabama, 2024

HCPCS Code Description Medicaid Payments Claims
87635 Sars-cov-2 covid-19 amp prb $9,571 10
87880 Strep a assay w/optic $5,623 10
87804 Influenza assay w/optic $3,798 10
87633 Resp virus 12-25 targets $2,756 1
87428 Sarscov & inf vir a&b ag ia $583 1
87426 Sarscov coronavirus ag ia $561 2
87502 Influenza dna amp probe $531 1
80305 Drug test prsmv dir opt obs $501 4
85025 Complete cbc w/auto diff wbc $127 1
80053 Comprehen metabolic panel $108 1
81003 Urinalysis auto w/o scope $82 2

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.



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