In 2024, Medicaid providers in Hickory billed a total of $10,479,305 for services in the Alcohol and Drug Abuse Treatment category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 25.6% increase from 2023, when claims for these services amounted to $8,345,934.
Medicaid, a public health insurance program operated by the states with joint federal and state funding, covers eligible low-income people including families, seniors, children, and individuals with disabilities, making it a significant component of the nation’s health care system. More information on funding can be found at the Commonwealth Fund.
Because Medicaid is funded by taxpayers, trends in local billing help illustrate changes in how community health care dollars are spent.
The “Alcohol and Drug Abuse Treatment” category encompasses a range of Medicaid-billed services organized by corresponding care based on standardized HCPCS and CPT code classifications. Each code was assigned to one service category for this analysis to prevent duplicated counts, ensuring accurate comparisons and rankings across years.
Alcohol and Drug Abuse Treatment ranked as the third-highest Medicaid payment category in Hickory in 2024, even as overall Medicaid spending increased across several categories.
Statewide, this category ranked fourth in North Carolina by total payment volume for 2024.
During the five-year period leading to 2024, Medicaid spending on Alcohol and Drug Abuse Treatment services in Hickory grew by $5,875,582, or 127.6%. This rise included several years of sharper growth, particularly in 2020 and 2021.
Although these services were utilized throughout Hickory, spending was largely focused within certain ZIP codes. In 2024, ZIP code 28602 saw payments totaling $9,759,008, while 28601 had $720,296. Altogether, these two ZIP codes made up 100% of the city’s Medicaid payments for Alcohol and Drug Abuse Treatment that year.
Within this category, Medicaid funds were concentrated among a relatively small selection of individual billing codes.
Compared with a 25.6% jump in Medicaid Alcohol and Drug Abuse Treatment payments between 2024 and 2023 in Hickory, total Medicaid claims citywide across all categories were up only 0.4% during the same span.
Data from the Centers for Medicare & Medicaid Services show that combined federal and state Medicaid outlays reached about $871.7 billion in fiscal year 2023, or 18% of U.S. health spending. That figure climbed from roughly $613.5 billion in 2019, preceding the COVID-19 pandemic.
This increase reflects nearly 40% growth over a few years, spurred by more enrollees and greater service use during and after the pandemic.
Recent federal budget measures signed under the Trump administration seek to limit federal Medicaid funding and change parts of its structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, aims to reduce federal Medicaid costs by more than $1 trillion over the next decade. The policy introduces changes like work requirements and higher cost-sharing, which could affect coverage and lower funding for some groups, potentially increasing state responsibilities as federal support growth slows despite the program serving many Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $4,603,722 | 50.8% |
| 2021 | $6,239,751 | 35.5% |
| 2022 | $6,776,219 | 8.6% |
| 2023 | $8,345,933 | 23.2% |
| 2024 | $10,479,304 | 25.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $21,945,680 | 32.4% |
| 2 | Evaluation and Management | $14,970,483 | 22.1% |
| 3 | Alcohol and Drug Abuse Treatment | $10,479,304 | 15.5% |
| 4 | Medicine Services and Procedures | $10,414,822 | 15.4% |
| 5 | Medical And Surgical Supplies | $2,345,199 | 3.5% |
| 6 | Temporary National Codes (Non-Medicare) | $1,650,317 | 2.4% |
| 7 | Pathology and Laboratory Procedures | $1,583,635 | 2.3% |
| 8 | Dental Services | $1,541,208 | 2.3% |
| 9 | Surgery | $961,061 | 1.4% |
| 10 | Durable Medical Equipment | $859,173 | 1.3% |
| 11 | Radiology Procedures | $445,356 | 0.7% |
| 12 | Procedures / Professional Services | $322,560 | 0.5% |
| 13 | Drugs Administered Other than Oral Method | $111,804 | 0.2% |
| 14 | Ambulance and Other Transport Services and Supplies | $78,066 | 0.1% |
| 15 | Anesthesia | $55,719 | 0.1% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $45,728 | 0.1% |
| 17 | Temporary Codes | $5,585 | <0.1% |
| 18 | Enteral and Parenteral Therapy | $4,617 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H0020 | Alcohol and/or drug services | $4,227,465 | 34 |
| H0040 | Assert comm tx pgm per diem | $2,097,296 | 23 |
| H0036 | Comm psy face-face per 15min | $1,762,562 | 56 |
| H2022 | Com wrap-around sv, per diem | $625,820 | 13 |
| H2014 | Skills train and dev, 15 min | $500,069 | 12 |
| H0015 | Alcohol and/or drug services | $485,563 | 22 |
| H2025 | Supp maint employ, 15 min | $254,548 | 11 |
| H2015 | Comp comm supp svc, 15 min | $251,794 | 11 |
| H0038 | Self-help/peer svc per 15min | $151,958 | 26 |
| H2011 | Crisis interven svc, 15 min | $99,250 | 11 |
| H2035 | A/d tx program, per hour | $22,975 | 1 |
| H0033 | Oral med adm direct observe | $0 | 9 |
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.
