Medicaid providers in Pelham billed $272,378 for dental services in 2024, according to data available from the U.S. Department of Health and Human Services Medicaid Provider Spending database. That figure reflects a 21.7% increase over 2023, when claims for these services totaled $223,775.
Medicaid, a public health insurance program funded cooperatively by state and federal governments, provides coverage to low-income families and individuals, seniors, children, and people with disabilities, making it a cornerstone of the U.S. health care system.
Since Medicaid spending reflects the distribution of taxpayer dollars, shifts in local billing help illustrate how health care resources are allocated within a community.
The “Dental Services” category encompasses a collection of services billed to Medicaid, organized by the type of dental care performed according to standardized HCPCS and CPT code ranges. Each billing code is classified into a single category by matching code prefixes and numeric groupings, so related treatments can be analyzed together without duplicating data or skewing rankings over time.
While several Medicaid service categories saw increased spending, Dental Services ranked third in total Medicaid payments in Pelham for 2024.
At the state level, Dental Services placed ninth for total Medicaid payments across Alabama in 2024.
Looking back over five years leading up to 2024, Medicaid payments for Dental Services in Pelham rose by $117,100, or 75.4%. Certain years, notably 2021 and 2022, saw especially rapid growth year over year.
Spending on Dental Services was spread throughout Pelham, though payments were concentrated in a small number of ZIP codes. The ZIP code 35124, for instance, accounted for $272,377 of Dental Services spending in 2024, which represented all Medicaid dental payments in the city for that year.
Dental Services payments were also concentrated among a few specific billing codes within the broader Medicaid category.
In comparison, Medicaid payments for Dental Services in Pelham grew 21.7% from 2023 to 2024, paralleling the 21.5% increase seen for all Medicaid claims in the city during that span.
Centers for Medicare & Medicaid Services data reports that combined federal and state Medicaid expenditures totaled about $871.7 billion in fiscal 2023, roughly 18% of all U.S. health spending, and up from $613.5 billion in 2019, just before the start of the COVID-19 pandemic.
That increase of around 40% in only a few years is mainly attributed to more enrollment and increased service usage during and after the pandemic period.
Recent federal budget measures under the Trump administration have proposed significant changes to Medicaid, including major funding cuts and restructuring. The “One Big Beautiful Bill Act,” for example, became law in 2025 and is forecast to reduce federal Medicaid funding by more than $1 trillion over the next decade. The act adds work requirements and greater cost-sharing, which could result in lower federal support and coverage for some recipients, increasing the burden on states even as Medicaid continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $155,278 | -13.5% |
| 2021 | $205,655 | 32.4% |
| 2022 | $233,725 | 13.6% |
| 2023 | $223,774 | -4.3% |
| 2024 | $272,377 | 21.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Pathology and Laboratory Procedures | $7,095,926 | 83.6% |
| 2 | Medicine Services and Procedures | $302,476 | 3.6% |
| 3 | Dental Services | $272,377 | 3.2% |
| 4 | Evaluation and Management | $202,826 | 2.4% |
| 5 | Durable Medical Equipment | $190,511 | 2.2% |
| 6 | Orthotic Procedures and services | $172,385 | 2% |
| 7 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $119,661 | 1.4% |
| 8 | National Codes Established for State Medicaid Agencies | $115,717 | 1.4% |
| 9 | Vision Services | $10,282 | 0.1% |
| 10 | Temporary National Codes (Non-Medicare) | $1,970 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| D0120 | Periodic oral evaluation | $119,764 | 76 |
| D0272 | Dental bitewings two images | $62,999 | 62 |
| D0330 | Panoramic image | $46,117 | 42 |
| D0140 | Limit oral eval problm focus | $11,277 | 23 |
| D0274 | Bitewings four images | $10,228 | 25 |
| D0220 | Intraoral periapical first | $8,957 | 33 |
| D0150 | Comprehensve oral evaluation | $8,470 | 15 |
| D0230 | Intraoral periapical ea add | $3,349 | 7 |
| D0145 | Oral evaluation, pt < 3yrs | $1,212 | 4 |
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.
