In 2024, Medicaid providers in East Orange billed $35,958,720 for Alcohol and Drug Abuse Treatment services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 13.2% rise compared to 2023, when claims for these services totaled $31,778,650.
Medicaid is a public insurance program, administered by the states, with joint funding from federal and state governments. The program covers low-income individuals, families, seniors, children, and people with disabilities, making it a central component of the U.S. health system. More details can be found here.
Because Medicaid payments are funded by taxpayers, shifts in local billing trends reveal how public health care resources are distributed within communities.
The “Alcohol and Drug Abuse Treatment” category includes a set of Medicaid-billed services defined by the care provided, based on standardized HCPCS and CPT code groups. Billing codes are each assigned to a single service category for this analysis, using uniform code prefixes and ranges to compare related services, avoid counting overlaps, and maintain accuracy in rankings over time.
Alcohol and Drug Abuse Treatment led all service categories in East Orange by total Medicaid spending in 2024, continuing a broader trend of increased payments across multiple care types.
Statewide in New Jersey, Alcohol and Drug Abuse Treatment also ranked first by total Medicaid payments during 2024.
Between 2019 and 2024, East Orange saw Medicaid payments for Alcohol and Drug Abuse Treatment rise by $13,249,018, or 58.3%. Spending growth picked up during certain timeframes, with notable annual jumps reported in 2021 and 2023.
Although these payments were made citywide, a few ZIP codes accounted for most spending. In 2024, Medicaid payments in the Alcohol and Drug Abuse Treatment category were highest in ZIP codes 07018 ($33,192,310) and 07017 ($2,766,409), with these two areas making up 100% of East Orange’s total for this service group.
Within the Alcohol and Drug Abuse Treatment category, payments were also concentrated among a small set of individual billing codes.
Looking at all claim categories, Medicaid payments linked to Alcohol and Drug Abuse Treatment in East Orange rose 13.2% from 2023 to 2024, while overall Medicaid claim spending in the city grew by 3.1% in the same period.
Centers for Medicare & Medicaid Services figures show combined federal and state Medicaid spending reached about $871.7 billion in fiscal year 2023. That was roughly 18% of all U.S. health care expenditures, a significant increase from about $613.5 billion in 2019, before the COVID-19 pandemic.
This change reflects a roughly 40% expansion over several years, propelled by broader enrollment and greater usage during and after the pandemic period.
Recent federal budget measures under the Trump administration have proposed major reductions to federal Medicaid funding and adjustments to the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to lower federal Medicaid spending by more than $1 trillion in the next decade. The legislation also introduces work requirements and heightened cost-sharing, changes that may reduce both coverage and funding for certain beneficiaries. More program costs are likely to shift to states, slowing the pace of federal Medicaid growth, even as the program continues serving millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $22,709,702 | 15.1% |
| 2021 | $27,237,630 | 19.9% |
| 2022 | $27,366,116 | 0.5% |
| 2023 | $31,778,650 | 16.1% |
| 2024 | $35,958,720 | 13.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $35,958,720 | 43% |
| 2 | National Codes Established for State Medicaid Agencies | $28,755,872 | 34.4% |
| 3 | Evaluation and Management | $7,115,012 | 8.5% |
| 4 | Temporary National Codes (Non-Medicare) | $5,294,253 | 6.3% |
| 5 | Medicine Services and Procedures | $3,332,802 | 4% |
| 6 | Procedures / Professional Services | $1,272,305 | 1.5% |
| 7 | Surgery | $620,320 | 0.7% |
| 8 | Ambulance and Other Transport Services and Supplies | $388,852 | 0.5% |
| 9 | Radiology Procedures | $260,079 | 0.3% |
| 10 | Dental Services | $244,221 | 0.3% |
| 11 | Pathology and Laboratory Procedures | $176,452 | 0.2% |
| 12 | Administrative, Miscellaneous and Investigational | $41,760 | <0.1% |
| 13 | Medical And Surgical Supplies | $35,770 | <0.1% |
| 14 | Drugs Administered Other than Oral Method | $35,356 | <0.1% |
| 15 | Temporary Codes | $30,547 | <0.1% |
| 16 | Orthotic Procedures and services | $26,686 | <0.1% |
| 17 | Vision Services | $24,405 | <0.1% |
| 18 | Miscellaneous Medical Services | $114 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H2016 | Comp comm supp svc, per diem | $28,624,480 | 20 |
| H0035 | Mh partial hosp tx under 24h | $2,977,313 | 24 |
| H0019 | Alcohol and/or drug services | $1,790,448 | 20 |
| H2021 | Com wrap-around sv, 15 min | $1,789,565 | 36 |
| H0036 | Comm psy face-face per 15min | $562,556 | 29 |
| H2015 | Comp comm supp svc, 15 min | $111,256 | 18 |
| H0006 | Alcohol and/or drug services | $61,088 | 11 |
| H0015 | Alcohol and/or drug services | $20,576 | 2 |
| H0039 | Asser com tx face-face/15min | $20,157 | 5 |
| H0048 | Spec coll non-blood:a/d test | $1,142 | 10 |
| H0003 | Alcohol and/or drug screenin | $133 | 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.
