Leesburg Medicaid payments for pathology and lab services up 8.2% in 2024

Dr. Mehmet Oz CMS Administrator
Dr. Mehmet Oz CMS Administrator
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In 2024, Medicaid providers in Leesburg submitted $41,761 in claims for Pathology and Laboratory Procedures, as reported by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was an 8.2% rise over 2023, when the total for such services reached $38,588.

Medicaid is a public insurance program operated by states and funded collaboratively by federal and state governments. The program serves low-income people and families, seniors, children, and individuals with disabilities. It is a major component of the U.S. health care system.

Because taxpayer dollars fund Medicaid payments, shifts in billing activity reflect how public health care funding is dispersed locally.

The Pathology and Laboratory Procedures group contains services organized by care type using standardized HCPCS and CPT coding. In this review, every billing code was attributed to just one service group following established code prefix and number range criteria, helping avoid code overlaps while supporting consistent analysis and fair year-to-year ranking.

Spending went up for several Medicaid service groups, but Pathology and Laboratory Procedures placed eighth in Leesburg by total Medicaid payments made during 2024.

On the state level, Pathology and Laboratory Procedures was Florida’s sixth largest Medicaid service category for total payments in 2024.

Between 2019 and 2024, Medicaid spending for Pathology and Laboratory Procedures in Leesburg rose by $444,305, or 91.4%, with periods of faster growth — in particular, there were prominent yearly increases in 2023 and 2022.

While Medicaid spending on Pathology and Laboratory Procedures was available citywide, the majority of payments were concentrated in just two ZIP codes. In 2024, ZIP code 34788 accounted for $38,748, while 34748 saw $3,012. Combined, those two ZIPs represented 100% of all Leesburg Medicaid payments in this category last year.

Payments in this service group were also clustered among a handful of specific billing codes.

To compare, Medicaid spending linked to Pathology and Laboratory Procedures in Leesburg’s Medicaid system grew 8.2% between 2024 and 2023. In contrast, payment growth was 19.4% across all Medicaid service types citywide during the same timeframe.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid outlays climbed to roughly $871.7 billion during the 2023 fiscal year. This represented about 18% of all national health care expenses and was a steep increase from roughly $613.5 billion in 2019 before the COVID-19 pandemic.

This uptick equals nearly 40% growth in just a few years, largely attributed to expanded Medicaid coverage and greater use of health care services throughout the pandemic and its aftermath.

Federal legislation passed under the Trump administration brought major proposals to decrease federal Medicaid outlays and amend program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid expenditures by more than $1 trillion over the next 10 years with new elements, such as work requirements and higher cost-sharing provisions, possibly lowering coverage and funding for some groups. These policy changes are set to pass more cost responsibility to state budgets and restrict federal spending increases, though Medicaid continues to support millions of Americans.

Medicaid Payments Tied to Pathology and Laboratory Procedures in Leesburg, Florida Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $486,066 -16%
2021 $211,754 -56.4%
2022 $54,231 -74.4%
2023 $38,587 -28.8%
2024 $41,761 8.2%
Top Categories by Medicaid Payments in Leesburg, Florida, 2024

Rank Category Medicaid Payments Share of City Total
1 Temporary National Codes (Non-Medicare) $10,315,190 69.9%
2 National Codes Established for State Medicaid Agencies $1,727,995 11.7%
3 Alcohol and Drug Abuse Treatment $1,096,799 7.4%
4 Evaluation and Management $950,821 6.4%
5 Medicine Services and Procedures $268,517 1.8%
6 Durable Medical Equipment $155,156 1.1%
7 Surgery $144,872 1%
8 Pathology and Laboratory Procedures $41,761 0.3%
9 Dental Services $27,177 0.2%
10 Radiology Procedures $21,071 0.1%
11 Durable medical equipment (DME) Medicare administrative contractors (MACs) $5,023 <0.1%
12 Procedures / Professional Services $467 <0.1%
13 Medical And Surgical Supplies $173 <0.1%
14 Drugs Administered Other than Oral Method $0 <0.1%
14 Temporary Codes $0 <0.1%
Top 20 HCPCS Codes Within the Pathology and Laboratory Procedures Category in Leesburg, Florida, 2024

HCPCS Code Description Medicaid Payments Claims
87428 Sarscov & inf vir a&b ag ia $28,139 10
87880 Strep a assay w/optic $5,106 12
87807 Rsv assay w/optic $3,817 10
80307 Drug test prsmv chem anlyzr $2,020 4
87502 Influenza dna amp probe $687 5
87811 Sars-cov-2 covid19 w/optic $652 4
87804 Influenza assay w/optic $649 4
85025 Complete cbc w/auto diff wbc $527 66
80053 Comprehen metabolic panel $79 42
81001 Urinalysis auto w/scope $20 26
84484 Assay of troponin quant $15 4
83690 Assay of lipase $12 10
87086 Urine culture/colony count $11 7
83735 Assay of magnesium $6 3
82248 Bilirubin direct $6 2
85610 Prothrombin time $5 6
81025 Urine pregnancy test $2 4
82077 Assay spec xcp ur&breath ia $0 2
85730 Thromboplastin time partial $0 1
86141 C-reactive protein hs $0 1

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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