Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows Medicaid providers in Lihue submitted $1,310,245 in bills for Medicine Services and Procedures in 2024. This amount represents an 85% jump from 2023, when $708,198 was claimed for the same services.
Medicaid is operated by states and receives joint financial support from federal and state governments, according to the Commonwealth Fund. It provides coverage for low-income people and families—including seniors, children, and individuals with disabilities—and is a significant component of the U.S. health care system.
Since Medicaid is funded by taxpayers, shifts in local billing patterns reflect how public health care funds are distributed within a community.
The “Medicine Services and Procedures” category includes a set of Medicaid-billed services specified by standardized HCPCS and CPT codes. For this report, billing code assignments used common prefixes and defined numeric intervals to categorize services together, remove duplicate counts, and enable consistent year-over-year comparison and ranking.
Among all service types, Medicine Services and Procedures placed third in overall Medicaid payments in Lihue for 2024, reflecting increased spending in several areas.
Statewide in Hawaii, Medicine Services and Procedures ranked second in total Medicaid payments for 2024.
Across the five years leading to 2024, Lihue providers’ Medicaid payments for this category grew by $888,434, or 210.6%. Some periods saw sharper increases, notably in 2021 and 2022.
Although care in the Medicine Services and Procedures category spanned the city, funding was concentrated in few ZIP codes—with the highest payment in 2024 going to ZIP code 96766, amounting to $1,310,245. Thus, the leading ZIP code made up 100% of the city’s Medicaid payments for this service type that year.
Medicaid spending in this category was also clustered among a small group of billing codes.
When compared with all categories in Lihue, Medicaid payments for Medicine Services and Procedures increased by 85% from 2023 to 2024. Overall Medicaid claim changes in Lihue during this time rose 20.2%.
The Centers for Medicare & Medicaid Services reports combined federal and state Medicaid costs reached about $871.7 billion in fiscal year 2023, roughly 18% of overall U.S. health expenditures, up from approximately $613.5 billion in 2019 before COVID-19 was declared a pandemic.
This growth of around 40% over several years was mainly due to higher enrollment and use of services during and after the pandemic.
Recent Trump administration federal budget measures included major plans to cut Medicaid funding at the national level and alter the program. For example, the “One Big Beautiful Bill Act,” signed in 2025, is expected to reduce federal Medicaid spending by over $1 trillion over 10 years while introducing work requirements and increased cost-sharing. These changes could impact coverage and state budgeting, potentially reducing the funding available as demand for Medicaid remains high.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $421,811 | -26.3% |
| 2021 | $630,784 | 49.5% |
| 2022 | $713,644 | 13.1% |
| 2023 | $708,197 | -0.8% |
| 2024 | $1,310,245 | 85% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $4,199,616 | 52.1% |
| 2 | Drugs Administered Other than Oral Method | $1,343,909 | 16.7% |
| 3 | Medicine Services and Procedures | $1,310,245 | 16.3% |
| 4 | Radiology Procedures | $571,792 | 7.1% |
| 5 | Procedures / Professional Services | $215,836 | 2.7% |
| 6 | Dental Services | $203,289 | 2.5% |
| 7 | Temporary National Codes (Non-Medicare) | $58,529 | 0.7% |
| 8 | Medical And Surgical Supplies | $41,689 | 0.5% |
| 9 | Durable Medical Equipment | $37,714 | 0.5% |
| 10 | Pathology and Laboratory Procedures | $29,332 | 0.4% |
| 11 | Surgery | $24,017 | 0.3% |
| 12 | Alcohol and Drug Abuse Treatment | $10,703 | 0.1% |
| 13 | Prosthetic Procedures | $5,111 | 0.1% |
| 14 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $2,387 | <0.1% |
| 15 | Coronavirus Diagnostic Panel | $1,009 | <0.1% |
| 16 | Temporary Codes | $12 | <0.1% |
| 17 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 17 | Outpatient PPS | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90999 | Unlisted dialysis procedure | $857,866 | 11 |
| 90837 | Psytx w pt 60 minutes | $91,348 | 16 |
| 93306 | Tte w/doppler complete | $64,798 | 25 |
| 97110 | Therapeutic exercises | $59,065 | 13 |
| 97140 | Manual therapy 1/> regions | $58,595 | 23 |
| 90833 | Psytx w pt w e/m 30 min | $25,047 | 12 |
| 97530 | Therapeutic activities | $24,711 | 12 |
| 96413 | Chemo iv infusion 1 hr | $13,177 | 11 |
| 92083 | Extended visual field xm | $12,841 | 11 |
| 96360 | Hydration iv infusion init | $12,310 | 5 |
| 92250 | Fundus photography w/i&r | $12,307 | 15 |
| 96361 | Hydrate iv infusion add-on | $10,719 | 10 |
| 92060 | Sensorimotor examination | $10,472 | 11 |
| 92025 | Cptrized corneal topography | $8,815 | 14 |
| 92014 | Compre oph exam est pt 1/> | $8,378 | 11 |
| 93005 | Electrocardiogram tracing | $7,537 | 12 |
| 90791 | Psych diagnostic evaluation | $3,953 | 3 |
| 96365 | Ther/proph/diag iv inf init | $3,810 | 13 |
| 97162 | Pt eval mod complex 30 min | $3,678 | 8 |
| 97161 | Pt eval low complex 20 min | $3,562 | 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.