Plainville Medicaid payments for pathology and lab procedures reach $71,449 in 2024

Providers in Plainville received $71,449 in Medicaid payments for Pathology and Laboratory Procedures in 2024, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents a 47.3% jump from 2023, when claims for these services totaled $48,491.

Medicaid is a government health insurance program managed by the states and financed jointly by federal and state governments. Serving low-income individuals and families, seniors, children, and people with disabilities, it remains one of the core elements of the U.S. health care system.

Since Medicaid payments use taxpayer funds, changes in local billing activity reflect how community health dollars are distributed.

The “Pathology and Laboratory Procedures” category includes a set of Medicaid-billed procedures defined by the care provided, using standardized HCPCS and CPT code clusters. Each code in this analysis was grouped into a single service category based on its prefix and numeric range, helping to track related services, avoid double counting, and maintain consistency in rankings over time.

While several service categories saw higher Medicaid spending, Pathology and Laboratory Procedures ranked fourth for total Medicaid payments in Plainville in 2024.

Statewide in Massachusetts, the Pathology and Laboratory Procedures category held the seventh position by Medicaid payments in 2024.

Over the five years before 2024, Medicaid payments connected to Pathology and Laboratory Procedures in Plainville grew by $67,004, representing a 1507.3% increase. The pace of growth accelerated at certain times, with prominent annual gains reported in 2022 and 2023.

Spending for Pathology and Laboratory Procedures was found throughout Plainville, but payments mainly originated from a few ZIP codes. In 2024, ZIP code 02762 accounted for $71,448, representing 100% of payments for this category in the city that year.

Most Medicaid spending within the Pathology and Laboratory Procedures category was focused on a select group of billing codes.

Comparatively, the 47.3% increase for Pathology and Laboratory Procedures in Plainville between 2024 and 2023 exceeded the overall 23.7% growth for all Medicaid claim categories in the city during that period.

According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid spending reached about $871.7 billion in fiscal year 2023. That makes up roughly 18% of total health expenditures nationally, rising from around $613.5 billion in 2019, before the COVID-19 pandemic.

This represents around 40% growth in just a few years, attributed largely to expanded enrollment and higher service use during and following the pandemic.

Federal budget legislation signed under the Trump administration has featured major proposals to reduce federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid funding by over $1 trillion over a decade and introduces elements like work requirements and more cost-sharing, which could limit coverage and funding for certain beneficiaries. These changes are likely to shift more financial responsibility to states and slow the growth of federal Medicaid support, although tens of millions of Americans would continue receiving coverage.

Note: HCPCS codes are provided for reference within the category. The article’s category totals and rankings are based on standardized service groupings rather than individual codes.

Information in this article comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original source data can be accessed here.