Elm Grove Medicaid billing for vision services reaches $5,361 in 2024

In 2024, Elm Grove Medicaid providers billed a total of $5,361 for services under the Vision Services category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That amount reflects a 1675.2% increase from 2023, when providers billed $302 for similar services.

Medicaid, a public health insurance initiative managed by states and funded by both federal and state governments, covers low-income residents, families, seniors, children and people with disabilities. It ranks as one of the nation’s largest health care programs.

With Medicaid financed by taxpayers, shifts in local billing show how community public health funding is distributed.

The Vision Services category collects Medicaid billing for a defined set of care types, organized according to standardized HCPCS and CPT code groupings. For this evaluation, each code matched a single service category based on code prefixes and numeric ranges, ensuring services are grouped accurately without duplicates and trend rankings remain correct over time.

Despite growth in Medicaid claims across categories, Vision Services ranked third by Medicaid payments in Elm Grove for 2024.

Statewide, Vision Services was 18th in Wisconsin by Medicaid payment total for the year.

Over the five years ending in 2024, Elm Grove’s Medicaid payments connected to Vision Services grew by $5,361, or 0%. Growth occurred at varied rates, with notable year-over-year increases logged in 2023 and 2022.

Spending for Vision Services was spread throughout Elm Grove but showed the heaviest concentration in a few ZIP codes. In 2024, ZIP code 53122 accounted for $5,360 of Vision Services-related Medicaid payments. The top ZIP code made up 100% of Medicaid billing for Vision Services in Elm Grove during the year.

Within Vision Services, Medicaid billing was concentrated in a small number of specific codes.

Between 2023 and 2024, Elm Grove saw a 1675.2% jump in Medicaid payments for Vision Services, in contrast to a 50.2% overall increase across all Medicaid claim groups in the city.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached approximately $871.7 billion in fiscal 2023, making up about 18% of total U.S. health expenses—well above the $613.5 billion total from 2019, before the COVID-19 pandemic.

This rise marks an increase of about 40% in just a few years, largely attributed to higher enrollment and greater use of services during and following the pandemic.

Recent federal budget measures passed under the Trump administration proposed substantial reductions in federal Medicaid support and changes to program structure. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid expenditure by over $1 trillion over the next 10 years and includes provisions such as work requirements and greater cost-sharing, potentially leading to lower coverage and funding for some recipients. These policy shifts are projected to move more of the cost responsibility to states and may limit the pace of growth in federal Medicaid funding, even as the program continues serving millions of Americans.

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.