In 2024, Medicaid providers in Salem billed a total of $14,803,505 for Alcohol and Drug Abuse Treatment services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 15.6% rise over 2023, when claims for the same services totaled $12,802,583.
Medicaid, which is administered by states and receives joint funding from both federal and state governments, provides coverage for low-income individuals and families, children, seniors, and people with disabilities. This makes Medicaid a major part of the U.S. health care system. More details are available in the explainer on Medicaid funding.
Since Medicaid is funded through taxpayer dollars, changes in billing activity locally demonstrate how community health resources are spent.
The Alcohol and Drug Abuse Treatment category combines Medicaid-billed services defined by the type of care provided, based on established HCPCS and CPT code groupings. For this analysis, each code was matched with one service category, using consistent prefixes and ranges; this method groups related care and avoids counting services more than once while providing accurate rankings through time.
Alcohol and Drug Abuse Treatment represented the highest Medicaid spending among all service categories in Salem in 2024.
Statewide, Alcohol and Drug Abuse Treatment was the second-largest Medicaid spending category in Virginia for 2024.
Between 2019 and 2024, Medicaid payments for Alcohol and Drug Abuse Treatment in Salem grew by $7,199,573, a 94.7% increase. Some years saw accelerated growth, including 2023 and 2021, with significant year-over-year rises reported.
While spending for Alcohol and Drug Abuse Treatment services occurred throughout Salem, payments were primarily concentrated in a small number of ZIP codes. In 2024, ZIP code 24153 accounted for $14,803,504 of such Medicaid payments, representing 100% of payments tied to this care category in Salem.
A small group of individual billing codes made up the majority of Medicaid payments for Alcohol and Drug Abuse Treatment services.
By comparison, Alcohol and Drug Abuse Treatment saw a 15.6% increase in Medicaid payments from 2023 to 2024 in Salem, whereas all Medicaid service categories in the city collectively rose by 6.2% during this interval.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures totaled approximately $871.7 billion in fiscal year 2023—about 18% of the nation’s health spending—which was a significant increase from roughly $613.5 billion in 2019, before the COVID-19 pandemic.
This growth represents an increase of about 40% over several years, largely driven by expanded enrollment and increased service use during and following the pandemic.
Recent federal budget measures under the Trump administration have included major proposals to reduce federal Medicaid support and restructure the program. The “One Big Beautiful Bill Act,” which became law in 2025, is projected to cut more than $1 trillion in federal Medicaid funding over 10 years, implementing work requirements and increased cost-sharing. These measures may reduce coverage and funding for some beneficiaries, shifting financial responsibility to states and potentially limiting growth in federal Medicaid aid, even as enrollment continues to be high.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $7,603,931 | 0.9% |
| 2021 | $8,294,932 | 9.1% |
| 2022 | $8,997,959 | 8.5% |
| 2023 | $12,802,583 | 42.3% |
| 2024 | $14,803,504 | 15.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $14,803,504 | 33.3% |
| 2 | Evaluation and Management | $13,460,180 | 30.3% |
| 3 | Medicine Services and Procedures | $4,470,717 | 10.1% |
| 4 | Temporary National Codes (Non-Medicare) | $4,442,509 | 1<0.1% |
| 5 | National Codes Established for State Medicaid Agencies | $3,254,810 | 7.3% |
| 6 | Radiology Procedures | $1,635,101 | 3.7% |
| 7 | Procedures / Professional Services | $662,793 | 1.5% |
| 8 | Surgery | $617,760 | 1.4% |
| 9 | Durable Medical Equipment | $345,768 | 0.8% |
| 10 | Pathology and Laboratory Procedures | $333,278 | 0.7% |
| 11 | Ambulance and Other Transport Services and Supplies | $308,296 | 0.7% |
| 12 | Medical And Surgical Supplies | $64,829 | 0.1% |
| 13 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $40,171 | 0.1% |
| 14 | Anesthesia | $17,373 | <0.1% |
| 15 | Drugs Administered Other than Oral Method | $7,390 | <0.1% |
| 16 | Outpatient PPS | $6,439 | <0.1% |
| 17 | Temporary Codes | $55 | <0.1% |
| 18 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 18 | Other Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H2022 | Com wrap-around sv, per diem | $9,885,436 | 23 |
| H0010 | Alcohol and/or drug services | $2,206,722 | 12 |
| H2014 | Skills train and dev, 15 min | $998,582 | 12 |
| H2036 | A/d tx program, per diem | $461,966 | 11 |
| H2020 | Ther behav svc, per diem | $450,072 | 8 |
| H2011 | Crisis interven svc, 15 min | $411,700 | 10 |
| H0035 | Mh partial hosp tx under 24h | $335,046 | 3 |
| H2000 | Comp multidisipln evaluation | $35,494 | 8 |
| H0015 | Alcohol and/or drug services | $18,106 | 1 |
| H0001 | Alcohol and/or drug assess | $376 | 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.
