Lorain Medicaid providers submitted $8,483,279 in claims for Alcohol and Drug Abuse Treatment services in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 4.1% rise from 2023, when claims for these services totaled $8,149,761.
Medicaid, funded jointly by state and federal governments and operated by states, offers public health insurance coverage for low-income individuals and families, seniors, children, and people with disabilities. It constitutes one of the largest components of the U.S. health system.
Because taxpayer dollars fund Medicaid, shifts in local billing levels reflect how communities allocate their public health care resources.
The “Alcohol and Drug Abuse Treatment” grouping includes Medicaid services based on the type of care provided, determined using standardized groupings of HCPCS and CPT codes. Billing codes were assigned to a single service category using defined code prefixes and numeric ranges in this analysis, allowing consistent year-to-year comparisons and accurate category rankings without double-counting.
Among service categories in Lorain, Alcohol and Drug Abuse Treatment ranked first by Medicaid payment totals in 2024.
Statewide in Ohio, Alcohol and Drug Abuse Treatment was the second-largest Medicaid payment category for 2024.
From 2019 through 2024, Lorain’s Medicaid payments for the Alcohol and Drug Abuse Treatment category increased by $587,938, or 6.5%. Some periods saw faster growth, notably in 2021 and 2020, when year-over-year increases were pronounced.
Although funding for Alcohol and Drug Abuse Treatment was distributed throughout Lorain, the bulk of payments came from a few ZIP codes. In 2024, ZIP code 44053 accounted for $8,482,269, while 44052 made up $1,010, meaning the top 2 ZIP codes represented 100% of Medicaid payments for this service category in the city that year.
Within the Alcohol and Drug Abuse Treatment service grouping, Medicaid spending was focused on a relatively small selection of billing codes.
For context, Lorain saw a 4.1% rise in Medicaid payments for Alcohol and Drug Abuse Treatment between 2024 and 2023, while all Medicaid claims in the city increased by 5% across categories over the same period.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023. That figure accounted for about 18% of all national health spending—up considerably from roughly $613.5 billion in 2019 before the COVID-19 pandemic.
That jump represents roughly 40% growth over a few years, largely driven by increased enrollment and higher use of services during and after the pandemic years.
Recent federal budget measures enacted under the Trump administration have included major proposals to curtail federal Medicaid funding and modify the program’s structure. The “One Big Beautiful Bill Act,” signed into law in 2025, is projected to reduce federal Medicaid expenditures by more than $1 trillion over the next 10 years and implements policies such as work requirements and increased cost-sharing, potentially reducing access and funding for some enrollees. These reforms are expected to shift a greater share of costs to states and slow federal Medicaid spending growth, while the program remains vital to millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $9,071,217 | 8% |
| 2021 | $9,938,509 | 9.6% |
| 2022 | $8,688,739 | -12.6% |
| 2023 | $8,149,761 | -6.2% |
| 2024 | $8,483,279 | 4.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $8,483,279 | 26.8% |
| 2 | National Codes Established for State Medicaid Agencies | $8,138,510 | 25.7% |
| 3 | Evaluation and Management | $6,786,568 | 21.5% |
| 4 | Medicine Services and Procedures | $3,865,433 | 12.2% |
| 5 | Radiology Procedures | $1,931,954 | 6.1% |
| 6 | Pathology and Laboratory Procedures | $827,188 | 2.6% |
| 7 | Surgery | $660,381 | 2.1% |
| 8 | Dental Services | $580,574 | 1.8% |
| 9 | Procedures / Professional Services | $273,449 | 0.9% |
| 10 | Drugs Administered Other than Oral Method | $26,778 | 0.1% |
| 11 | Ambulance and Other Transport Services and Supplies | $24,115 | 0.1% |
| 12 | Temporary Codes | $6,495 | <0.1% |
| 13 | Vision Services | $3,404 | <0.1% |
| 14 | Medical And Surgical Supplies | $3,402 | <0.1% |
| 15 | Anesthesia | $1,553 | <0.1% |
| 16 | Outpatient PPS | $172 | <0.1% |
| 17 | Administrative, Miscellaneous and Investigational | $36 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H2036 | A/d tx program, per diem | $3,392,438 | 25 |
| H0015 | Alcohol and/or drug services | $2,378,285 | 159 |
| H2019 | Ther behav svc, per 15 min | $1,259,234 | 245 |
| H0040 | Assert comm tx pgm per diem | $705,053 | 79 |
| H0011 | Alcohol and/or drug services | $487,287 | 14 |
| H2017 | Psysoc rehab svc, per 15 min | $161,360 | 35 |
| H0004 | Alcohol and/or drug services | $33,360 | 28 |
| H0005 | Alcohol and/or drug services | $19,636 | 13 |
| H0048 | Spec coll non-blood:a/d test | $18,507 | 51 |
| H0036 | Comm psy face-face per 15min | $13,315 | 13 |
| H1000 | Prenatal care atrisk assessm | $6,056 | 4 |
| H2020 | Ther behav svc, per diem | $5,148 | 1 |
| H0006 | Alcohol and/or drug services | $3,593 | 8 |
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.
