Somerset’s Medicaid providers billed $69,484,361 for Alcohol and Drug Abuse Treatment services in 2024, as shown in data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount marked a 2.3% rise compared to 2023, when $67,952,979 in claims were filed for similar services.
Medicaid is a public health insurance initiative managed by individual states with joint federal and state funding, according to the Commonwealth Fund. It provides coverage to low-income people and families, as well as seniors, children, and people with disabilities, making it a major component of the U.S. health care landscape.
Because Medicaid is taxpayer-funded, shifts in local billing levels illustrate how a community allocates public health care resources.
The Alcohol and Drug Abuse Treatment category covers a group of Medicaid-billed services grouped by care type using specific HCPCS and CPT codes. Each billing code was matched to one service category using uniform code prefixes and ranges, ensuring related services could be tracked together, removing double counting, and ensuring accurate year-over-year comparisons.
Although there was a rise in Medicaid spending in several categories, Alcohol and Drug Abuse Treatment took the top spot in Somerset by total Medicaid payments in 2024.
Statewide in New Jersey, Alcohol and Drug Abuse Treatment also received the highest total Medicaid payments in 2024.
From 2019 to 2024, Somerset’s Medicaid payments associated with Alcohol and Drug Abuse Treatment increased by $13,227,939—or 23.5%. The rate of spending grew faster in some years, with sharp annual increases seen in 2020 and 2023.
Spending on Alcohol and Drug Abuse Treatment services was concentrated in a few ZIP codes across Somerset. In 2024, the ZIP code with the highest Medicaid payments tied to this category was 08873, accounting for $69,484,360. Combined, the top ZIP code represented 100% of all Medicaid payments for Alcohol and Drug Abuse Treatment in Somerset in 2024.
Payments in this category were also clustered among just a handful of individual billing codes.
For comparison, Alcohol and Drug Abuse Treatment in Somerset saw a 2.3% billing increase between 2024 and 2023, while all Medicaid claim categories citywide together climbed 6.4% over the same period.
The Centers for Medicare & Medicaid Services report that combined federal and state Medicaid spending reached about $871.7 billion in the 2023 fiscal year, roughly 18% of total U.S. health expenditures, representing a steep rise from the $613.5 billion total reported in 2019, just before COVID-19.
This change reflects nearly 40% growth in a few years, fueled mainly by upticks in enrollment and utilization throughout and after the pandemic.
Major federal budget measures under the Trump administration have featured proposals to reduce federal Medicaid support and overhaul the program’s structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, aims to trim federal Medicaid spending by more than $1 trillion over the coming decade. It introduces work requirements and increases cost-sharing, which could mean reduced funding and coverage for some. These steps are projected to push more program costs to states and put a cap on the growth of federal funding, though Medicaid remains a lifeline for millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $56,256,422 | 21.8% |
| 2021 | $60,430,045 | 7.4% |
| 2022 | $62,287,719 | 3.1% |
| 2023 | $67,952,979 | 9.1% |
| 2024 | $69,484,360 | 2.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $69,484,360 | 44.6% |
| 2 | Evaluation and Management | $51,757,303 | 33.2% |
| 3 | Temporary National Codes (Non-Medicare) | $11,957,515 | 7.7% |
| 4 | National Codes Established for State Medicaid Agencies | $10,724,564 | 6.9% |
| 5 | Hearing Services | $7,882,271 | 5.1% |
| 6 | Medicine Services and Procedures | $3,826,465 | 2.5% |
| 7 | Prosthetic Procedures | $61,592 | <0.1% |
| 8 | Surgery | $61,097 | <0.1% |
| 9 | Dental Services | $29,533 | <0.1% |
| 10 | Radiology Procedures | $22,465 | <0.1% |
| 11 | Vision Services | $10,825 | <0.1% |
| 12 | Pathology and Laboratory Procedures | $2,919 | <0.1% |
| 13 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $2,288 | <0.1% |
| 14 | Durable Medical Equipment | $1,242 | <0.1% |
| 15 | Drugs Administered Other than Oral Method | $1,214 | <0.1% |
| 16 | Medical And Surgical Supplies | $815 | <0.1% |
| 17 | Procedures / Professional Services | $296 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H2016 | Comp comm supp svc, per diem | $67,467,036 | 36 |
| H0019 | Alcohol and/or drug services | $1,447,936 | 13 |
| H2021 | Com wrap-around sv, 15 min | $504,000 | 12 |
| H0004 | Alcohol and/or drug services | $62,224 | 12 |
| H0035 | Mh partial hosp tx under 24h | $3,162 | 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.
