Philadelphia Medicaid providers billed $283,847,187 for Alcohol and Drug Abuse Treatment services in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This amounted to a 13.9% increase over 2023, when claims for the same service type totaled $249,182,202.
Medicaid, a public health insurance program managed by states with joint federal and state funding, covers low-income individuals and families, seniors, children, and people with disabilities, making it a major component of the U.S. health care system. Learn more about program funding here.
Since Medicaid is taxpayer-funded, shifts in local billing levels highlight how health care resources are allocated across communities.
The Alcohol and Drug Abuse Treatment category encompasses services billed to Medicaid per standardized HCPCS and CPT code groups. This analysis assigned each billing code to a single category using established code ranges, ensuring related services could be reviewed together without double counting and keeping rankings consistent.
Although Medicaid outlays increased for several categories, Alcohol and Drug Abuse Treatment represented the leading category by total Medicaid payments in Philadelphia during 2024.
Statewide in Pennsylvania, Alcohol and Drug Abuse Treatment also ranked No. 1 in overall Medicaid payments in 2024.
Looking at the five years prior to 2024, Medicaid payments for Alcohol and Drug Abuse Treatment in Philadelphia expanded by $264,372,159, or 1357.5%. Growth escalated during some years, especially in 2022 and 2020.
While funding for this category was present citywide, the highest payments concentrated in several ZIP codes: 19139 saw $27,216,530 in payments, 19125 had $23,860,783, and 19123 recorded $23,593,039. In totals, the top 3 ZIP codes accounted for 26.3% of citywide Medicaid payments linked to Alcohol and Drug Abuse Treatment in 2024.
Within the category, a small number of billing codes accumulated most Medicaid payments.
From 2023 to 2024, citywide Medicaid payments for Alcohol and Drug Abuse Treatment were up 13.9%. For comparison, all Medicaid claim categories in Philadelphia collectively rose 1.7% during that same period.
Data from the Centers for Medicare & Medicaid Services indicate combined Medicaid spending by states and the federal government reached about $871.7 billion in the 2023 fiscal year. That amounted to roughly 18% of all U.S. national health expenditures, up sharply from $613.5 billion in 2019, prior to the COVID-19 pandemic.
The jump reflects close to 40% growth over a few years, influenced mainly by increased enrollment and greater service utilization tied to the pandemic and its aftermath.
Recent federal budget measures during the Trump administration included substantial proposals to trim federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” signed in 2025, is projected to reduce federal Medicaid outlays by over $1 trillion over the next decade, with new work requirements and increased cost-sharing that could lead to less funding or coverage for some individuals. States are expected to bear a larger share of Medicaid costs even as the program serves tens of millions of people nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $19,475,027 | 254% |
| 2021 | $43,977,489 | 125.8% |
| 2022 | $186,314,395 | 323.7% |
| 2023 | $249,182,202 | 33.7% |
| 2024 | $283,847,187 | 13.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $283,847,187 | 25.5% |
| 2 | National Codes Established for State Medicaid Agencies | $250,132,374 | 22.4% |
| 3 | Evaluation and Management | $204,490,831 | 18.3% |
| 4 | Medicine Services and Procedures | $174,849,023 | 15.7% |
| 5 | Ambulance and Other Transport Services and Supplies | $42,931,579 | 3.9% |
| 6 | Procedures / Professional Services | $41,047,678 | 3.7% |
| 7 | Temporary National Codes (Non-Medicare) | $32,046,714 | 2.9% |
| 8 | Radiology Procedures | $21,470,349 | 1.9% |
| 9 | Surgery | $14,269,968 | 1.3% |
| 10 | Dental Services | $12,076,643 | 1.1% |
| 11 | Enteral and Parenteral Therapy | $10,531,030 | 0.9% |
| 12 | Medical And Surgical Supplies | $8,743,191 | 0.8% |
| 13 | Vision Services | $6,205,354 | 0.6% |
| 14 | Pathology and Laboratory Procedures | $4,834,779 | 0.4% |
| 15 | Durable Medical Equipment | $2,552,193 | 0.2% |
| 16 | Orthotic Procedures and services | $1,409,979 | 0.1% |
| 17 | Drugs Administered Other than Oral Method | $1,252,186 | 0.1% |
| 18 | Anesthesia | $1,042,713 | 0.1% |
| 19 | Pathology and Laboratory Services | $511,961 | <0.1% |
| 20 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $176,302 | <0.1% |
| 21 | Temporary Codes | $85,005 | <0.1% |
| 22 | Prosthetic Procedures | $70,315 | <0.1% |
| 23 | Diagnostic Radiology Services | $65,918 | <0.1% |
| 24 | Outpatient PPS | $58,852 | <0.1% |
| 25 | Administrative, Miscellaneous and Investigational | $24,285 | <0.1% |
| 26 | Chemotherapy Drugs | $2,833 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H2036 | A/d tx program, per diem | $90,084,860 | 290 |
| H0039 | Asser com tx face-face/15min | $28,848,464 | 97 |
| H0032 | Mh svc plan dev by non-md | $27,750,623 | 222 |
| H2021 | Com wrap-around sv, 15 min | $25,943,184 | 171 |
| H0036 | Comm psy face-face per 15min | $20,806,497 | 234 |
| H0046 | Mental health service, nos | $13,556,340 | 95 |
| H2019 | Ther behav svc, per 15 min | $12,865,189 | 214 |
| H2034 | A/d halfway house, per diem | $11,376,969 | 68 |
| H0004 | Alcohol and/or drug services | $10,053,849 | 165 |
| H2011 | Crisis interven svc, 15 min | $8,227,602 | 120 |
| H0035 | Mh partial hosp tx under 24h | $7,588,796 | 55 |
| H0018 | Alcohol and/or drug services | $5,625,760 | 30 |
| H0006 | Alcohol and/or drug services | $4,756,765 | 59 |
| H0037 | Comm psy sup tx pgm per diem | $4,751,349 | 31 |
| H0013 | Alcohol and/or drug services | $3,993,944 | 72 |
| H0034 | Med trng & support per 15min | $2,964,488 | 609 |
| H0038 | Self-help/peer svc per 15min | $2,289,968 | 88 |
| H0015 | Alcohol and/or drug services | $892,552 | 34 |
| H0031 | Mh health assess by non-md | $399,653 | 102 |
| H0011 | Alcohol and/or drug services | $348,435 | 11 |
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.
