Duarte Medicaid providers submitted $4,760,928 in claims for services categorized as Alcohol and Drug Abuse Treatment in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represented a 93.6% climb from 2023, when $2,459,770 in claims were submitted under this category.
Medicaid, a public health insurance plan managed by states and funded through state and federal resources, serves low-income individuals and families, seniors, children, and people with disabilities, establishing its role as a fundamental segment in the U.S. healthcare system.
As Medicaid is funded by taxpayers, shifts in billing within a community highlight changes in how public healthcare dollars are distributed locally.
The “Alcohol and Drug Abuse Treatment” classification captures Medicaid-billed services according to the types of care provided, based on standardized HCPCS and CPT code groups. In this analysis, billing codes were grouped into service categories using established code prefixes and number ranges, facilitating the examination of like services together while avoiding overlap and maintaining accurate rankings through time.
Alcohol and Drug Abuse Treatment was the fifth-largest Medicaid category by payments in Duarte in 2024, even as Medicaid spending rose among numerous service types.
Statewide in California, Alcohol and Drug Abuse Treatment ranked fourth by total Medicaid payments that year.
Between 2019 and 2024, Medicaid-linked payments for Alcohol and Drug Abuse Treatment services in Duarte climbed $2,683,940, an increase of 129.2%. Notably, spending spiked during certain periods, with substantial year-over-year gains reported in both 2023 and 2022.
Although funding for these services was spread across Duarte, most payments were concentrated within a small subset of ZIP codes. In 2024, ZIP code 91010 accounted for $4,760,928, representing all Medicaid payments tied to the Alcohol and Drug Abuse Treatment category citywide that year.
A handful of billing codes also captured the majority of Medicaid payments within this treatment group in 2024.
To compare, Duarte saw a 93.6% bump in Medicaid payments for Alcohol and Drug Abuse Treatment between 2023 and 2024, while payments across all claim categories citywide changed by only 1.6% over the same period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures totaled about $871.7 billion in fiscal 2023, representing 18% of U.S. national health expenditures—rising steeply from approximately $613.5 billion in 2019 before the onset of COVID-19.
This jump denotes roughly 40% growth, mainly attributed to increased enrollment and use during and after pandemic years.
Recent federal spending legislation signed during the Trump administration proposed major reductions to federal Medicaid funding and plans to change the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to trim more than $1 trillion from federal Medicaid funding over the coming decade and enacts work requirements and higher out-of-pocket costs that may scale back funding and coverage for some groups. These shifts are anticipated to increase the state share of Medicaid costs and temper growth in federal support, as Medicaid continues providing coverage to millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $2,076,988 | -12.1% |
| 2021 | $1,854,778 | -10.7% |
| 2022 | $1,536,375 | -17.2% |
| 2023 | $2,459,770 | 60.1% |
| 2024 | $4,760,928 | 93.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Chemotherapy Drugs | $18,572,224 | 30.2% |
| 2 | Radiology Procedures | $13,495,100 | 21.9% |
| 3 | Pathology and Laboratory Procedures | $5,404,215 | 8.8% |
| 4 | Drugs Administered Other than Oral Method | $5,198,255 | 8.4% |
| 5 | Alcohol and Drug Abuse Treatment | $4,760,928 | 7.7% |
| 6 | Medicine Services and Procedures | $3,908,536 | 6.4% |
| 7 | Evaluation and Management | $3,016,132 | 4.9% |
| 8 | Temporary Codes | $1,909,201 | 3.1% |
| 9 | Procedures / Professional Services | $1,700,269 | 2.8% |
| 10 | Anesthesia | $1,211,342 | 2% |
| 11 | Administrative, Miscellaneous and Investigational | $639,379 | 1% |
| 12 | Pathology and Laboratory Services | $500,637 | 0.8% |
| 13 | Orthotic Procedures and services | $493,440 | 0.8% |
| 14 | Temporary National Codes (Non-Medicare) | $304,007 | 0.5% |
| 15 | Surgery | $240,028 | 0.4% |
| 16 | Dental Services | $138,682 | 0.2% |
| 17 | Outpatient PPS | $36,836 | 0.1% |
| 18 | Vision Services | $5,255 | <0.1% |
| 19 | National Codes Established for State Medicaid Agencies | $3,458 | <0.1% |
| 20 | Medical And Surgical Supplies | $915 | <0.1% |
| 21 | Coronavirus Diagnostic Panel | $61 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H2019 | Ther behav svc, per 15 min | $3,501,617 | 49 |
| H0031 | Mh health assess by non-md | $811,048 | 11 |
| H0032 | Mh svc plan dev by non-md | $392,005 | 37 |
| H0046 | Mental health service, nos | $56,255 | 7 |
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.
