In 2024, Medicaid providers in Mercersburg billed $39,815 for Dental Services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents an 8928.3% rise from 2023, when the total was $441 for these services.
Medicaid, a publicly funded health insurance program, is managed by states and financed both federally and by the states. It provides coverage for low-income people and families, seniors, children, and individuals with disabilities, making it a core element of the country’s health care system.
Because Medicaid funding comes from taxpayers, variations in local billing highlight the community-level distribution of public health care spending.
The Dental Services category consists of Medicaid claims grouped by service type, based on standardized HCPCS and CPT coding. For this report, codes were assigned to a single category using consistent code prefixes and numeric ranges to organize related care, prevent overlap, and maintain accurate rankings over time.
While payments rose in multiple categories, Dental Services ranked third for overall Medicaid spending in Mercersburg in 2024.
Statewide in Pennsylvania, Dental Services was 14th in total Medicaid payments during 2024.
Over the five years before 2024, Medicaid payments for Dental Services in Mercersburg increased $39,815, or 0%. Certain periods saw faster spending growth, with particularly large increases from year to year in 2023 and 2022.
Though dental claims were submitted across Mercersburg, the bulk of payments were limited to a small group of ZIP codes. ZIP code 17236 contributed $39,814, accounting for 100% of the city’s Medicaid dental payments in 2024.
Medicaid spending within Dental Services was also focused among a few main billing codes.
For context, the 8928.3% rise in Medicaid payments for Dental Services in Mercersburg between 2024 and 2023 compared to a 1620.8% increase seen across all Medicaid service categories in the city over the same period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid outlays reached approximately $871.7 billion in fiscal year 2023, accounting for about 18% of national health spending, up significantly from $613.5 billion in 2019, before the COVID-19 pandemic.
This rise marks roughly 40% growth in just a few years, mainly driven by greater enrollment and increased utilization during and following the pandemic.
Federal budget changes under the Trump administration have brought significant proposals to reduce federal Medicaid funding and alter program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut over $1 trillion in federal Medicaid spending in the next decade and introduces new work requirements and more cost-sharing, potentially impacting coverage and funding for some. These adjustments are likely to transfer more financial responsibility to states and restrict federal Medicaid growth, even as the program continues serving tens of millions across the country.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2022 | $357 | – |
| 2023 | $441 | 23.5% |
| 2024 | $39,814 | 8928.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $64,617 | 37.3% |
| 2 | Medicine Services and Procedures | $44,693 | 25.8% |
| 3 | Dental Services | $39,814 | 23% |
| 4 | Ambulance and Other Transport Services and Supplies | $23,950 | 13.8% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| D0120 | Periodic oral evaluation | $21,869 | 12 |
| D0274 | Bitewings four images | $7,978 | 11 |
| D0330 | Panoramic image | $4,350 | 7 |
| D0601 | Caries risk assess low risk | $4,030 | 11 |
| D0150 | Comprehensve oral evaluation | $1,247 | 2 |
| D0272 | Dental bitewings two images | $196 | 1 |
| D0220 | Intraoral periapical first | $144 | 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.
