Marlborough Medicaid providers billed $2,582,222 for Alcohol and Drug Abuse Treatment services in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 71.2% increase over 2023, when $1,507,923 in claims were recorded for these services.
Medicaid, a public health insurance program administered by the states and financed by both federal and state governments, covers low-income individuals and families, seniors, children, and people with disabilities. This makes it one of the largest sections of the U.S. health care system.
Because Medicaid is taxpayer-funded, variations in local billing patterns illustrate how public health resources are distributed in a community.
The “Alcohol and Drug Abuse Treatment” classification includes a range of Medicaid-billed services that are determined by type of care and organized into standardized HCPCS and CPT code groupings. For this evaluation, each billing code was assigned to one service category using specific code prefixes and numerical ranges, which allowed service types to be tracked together while preventing duplicate counts and ensuring accurate rankings over time.
Medicaid spending was up in several service categories, but Alcohol and Drug Abuse Treatment ranked seventh in Marlborough for total Medicaid payments in 2024.
Statewide, Alcohol and Drug Abuse Treatment was the third-largest Medicaid payment category in Massachusetts in 2024.
Between 2019 and 2024, Medicaid payments related to Alcohol and Drug Abuse Treatment in Marlborough rose by $328,426, or 14.6%. There were periods when annual growth picked up significantly, especially with noticeable increases seen in 2022 and 2022.
While Alcohol and Drug Abuse Treatment spending was distributed citywide, most payments originated from a few ZIP codes. ZIP code 01752 led Marlborough with $2,582,221 in Medicaid payments for Alcohol and Drug Abuse Treatment in 2024. The top ZIP code accounted for 100% of all Medicaid payments in the category that year.
Further, Medicaid spending within the Alcohol and Drug Abuse Treatment group was centered on just a small subset of billing codes.
Compared to the 71.2% growth in Alcohol and Drug Abuse Treatment payments in Marlborough from 2023 to 2024, all Medicaid claim categories in the city grew by 6.1% during the same time frame.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached about $871.7 billion in fiscal year 2023, representing roughly 18% of all U.S. health expenditures. This shows a sharp rise from about $613.5 billion in 2019, prior to the COVID-19 pandemic.
This rise equates to around 40% growth within a few years, largely driven by higher enrollment and greater service usage in the pandemic’s wake.
Recent federal budget measures during the Trump administration included major proposals to reduce federal Medicaid contributions and restructure the program. The “One Big Beautiful Bill Act,” enacted in 2025, aims to decrease federal Medicaid outlays by more than $1 trillion over the next decade with policy measures such as work requirements and expanded cost-sharing. These changes are anticipated to increase the burden on states and slow the growth of federal Medicaid aid, while the program continues supporting millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $2,253,795 | -58.7% |
| 2021 | $2,037,425 | -9.6% |
| 2022 | $2,354,766 | 15.6% |
| 2023 | $1,507,923 | -36% |
| 2024 | $2,582,221 | 71.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Pathology and Laboratory Procedures | $55,371,197 | 55% |
| 2 | Temporary National Codes (Non-Medicare) | $15,802,802 | 15.7% |
| 3 | National Codes Established for State Medicaid Agencies | $7,894,945 | 7.8% |
| 4 | Medicine Services and Procedures | $5,491,281 | 5.5% |
| 5 | Procedures / Professional Services | $4,875,239 | 4.8% |
| 6 | Enteral and Parenteral Therapy | $4,009,908 | 4% |
| 7 | Alcohol and Drug Abuse Treatment | $2,582,221 | 2.6% |
| 8 | Evaluation and Management | $2,162,030 | 2.1% |
| 9 | Ambulance and Other Transport Services and Supplies | $671,804 | 0.7% |
| 10 | Surgery | $490,650 | 0.5% |
| 11 | Drugs Administered Other than Oral Method | $404,933 | 0.4% |
| 12 | Dental Services | $381,074 | 0.4% |
| 13 | Radiology Procedures | $333,805 | 0.3% |
| 14 | Durable Medical Equipment | $139,012 | 0.1% |
| 15 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $31,291 | <0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $15,088 | <0.1% |
| 17 | Pathology and Laboratory Services | $14,595 | <0.1% |
| 18 | Medical And Surgical Supplies | $3,338 | <0.1% |
| 19 | Temporary Codes | $2,396 | <0.1% |
| 20 | Coronavirus Diagnostic Panel | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H0019 | Alcohol and/or drug services | $987,226 | 11 |
| H2019 | Ther behav svc, per 15 min | $895,884 | 12 |
| H2016 | Comp comm supp svc, per diem | $297,586 | 12 |
| H0031 | Mh health assess by non-md | $187,656 | 23 |
| H2011 | Crisis interven svc, 15 min | $97,244 | 17 |
| H0043 | Supported housing, per diem | $91,862 | 5 |
| H0046 | Mental health service, nos | $24,762 | 12 |
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.
