In 2024, Medicaid providers in Orem billed a total of $656,057 for Pathology and Laboratory Procedures, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 21.9% uptick from the $538,191 submitted in 2023 for the same category of services.
Medicaid is a state-operated public insurance program jointly funded by state and federal governments. It provides coverage for low-income individuals, families, seniors, children, and people with disabilities, making it a central part of the U.S. health care system.
Because Medicaid spending comes directly from taxpayer contributions, local changes in billing give insight into how community health care funds are utilized.
The “Pathology and Laboratory Procedures” group identifies services billed to Medicaid, classified by standardized HCPCS and CPT code groupings. For this analysis, every billing code was consistently placed in one service group by using distinct code ranges and prefixes, which allowed for accurate tracking and ranking while avoiding duplicate counts.
Pathology and Laboratory Procedures was the fifth-highest Medicaid service category by total payments in Orem for 2024, amid a general increase in Medicaid spending across several service types.
Statewide, Utah saw Pathology and Laboratory Procedures as the sixth-ranked Medicaid category for total payments in 2024.
From 2019 through 2024, Orem’s Medicaid payments for Pathology and Laboratory Procedures increased by $425,055, or 184%. The most significant year-over-year growth occurred in 2023 and 2020.
While Medicaid payments for these services were distributed citywide, most spending was focused in a small number of ZIP codes. In 2024, ZIP code 84058 accounted for $649,508 and 84057 made up $6,548. Together, these ZIP codes were responsible for 100% of the community’s Medicaid payments in this category for the year.
The majority of Medicaid payments for Pathology and Laboratory Procedures centered on only a select few billing codes within this service group.
Comparatively, Orem saw a 21.9% increase in Medicaid payments for Pathology and Laboratory Procedures between 2023 and 2024, outpacing the 4.5% year-over-year growth in total Medicaid claim categories across the city for the same interval.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending together reached about $871.7 billion in fiscal year 2023, representing nearly 18% of all national health expenditures, an increase from roughly $613.5 billion in 2019 before the onset of the COVID-19 pandemic.
This marks about 40% growth in a few years, propelled by expanded enrollment and increased use during and after the pandemic.
Recent federal budget measures under the Trump administration have proposed sharp reductions to federal Medicaid funding and broad program restructuring. The “One Big Beautiful Bill Act,” which became law in 2025, is anticipated to reduce federal Medicaid expenditures by more than $1 trillion over 10 years and introduces provisions such as work requirements and higher cost-sharing. These policies could lower benefits and funding for certain groups. The changes are expected to transfer more costs to individual states and slow federal Medicaid spending increases, even as the program remains vital for millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $231,001 | 27.3% |
| 2021 | $230,474 | -0.2% |
| 2022 | $241,891 | 5% |
| 2023 | $538,190 | 122.5% |
| 2024 | $656,056 | 21.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $2,485,764 | 23.5% |
| 2 | National Codes Established for State Medicaid Agencies | $2,476,538 | 23.4% |
| 3 | Evaluation and Management | $2,296,775 | 21.7% |
| 4 | Medicine Services and Procedures | $1,852,829 | 17.5% |
| 5 | Pathology and Laboratory Procedures | $656,056 | 6.2% |
| 6 | Ambulance and Other Transport Services and Supplies | $382,547 | 3.6% |
| 7 | Durable Medical Equipment | $175,812 | 1.7% |
| 8 | Dental Services | $113,404 | 1.1% |
| 9 | Surgery | $78,074 | 0.7% |
| 10 | Anesthesia | $33,847 | 0.3% |
| 11 | Medical And Surgical Supplies | $24,431 | 0.2% |
| 12 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $5,015 | <0.1% |
| 13 | Procedures / Professional Services | $87 | <0.1% |
| 14 | Radiology Procedures | $72 | <0.1% |
| 15 | Temporary Codes | $1 | <0.1% |
| 16 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 80307 | Drug test prsmv chem anlyzr | $645,611 | 11 |
| 80305 | Drug test prsmv dir opt obs | $10,114 | 32 |
| 85027 | Complete cbc automated | $215 | 38 |
| 80053 | Comprehen metabolic panel | $114 | 18 |
| 81001 | Urinalysis auto w/scope | $0 | 7 |
| 87400 | Influenza a/b each ag ia | $0 | 2 |
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.
