Lexington Medicaid providers submitted $35,681 in 2024 for services within the Vision Services category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 5.8% increase from 2023, when providers billed $33,727 for the same services.
Medicaid is a public health insurance program administered by states and funded jointly by federal and state governments. The program provides coverage to low-income individuals and families, children, seniors, and people with disabilities, making it one of the largest U.S. health care programs.
As taxpayer-funded public insurance, shifts in Medicaid billing help show how community health spending is distributed.
The Vision Services category refers to a standardized set of Medicaid-billed services classified by the care provided and determined by grouping HCPCS and CPT code prefixes. For this report, billing codes were categorized according to consistent prefix patterns and number ranges, organizing similar services for analysis and avoiding duplication to ensure accurate historical rankings.
Spending rose across multiple Medicaid categories, but Vision Services was seventh in total Medicaid payments in Lexington for 2024.
Statewide in Tennessee, Vision Services ranked 19th in total Medicaid payments in 2024.
Across the five years preceding 2024, Vision Services-related Medicaid payments in Lexington grew by $3,208, or 9.9%. Spending rapidly increased during select stretches, with notable jumps seen in both 2020 and 2021.
Medicaid claims for Vision Services were billed citywide but remained largely concentrated in a few ZIP codes. For 2024, ZIP code 38351 represented the highest payment total for Vision Services, accounting for $35,680 and all Medicaid spending in that category for Lexington.
Within Vision Services, most Medicaid payments were tied to a small range of billing codes.
Comparing this 5.8% annual increase in Lexington’s Vision Services with the entire Medicaid program, claim payments citywide rose 19.4% across all categories from 2023 to 2024 during the same period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending together totaled about $871.7 billion for fiscal year 2023, representing about 18% of total U.S. health costs, up sharply from approximately $613.5 billion in 2019 before the COVID-19 pandemic.
This marks an increase near 40% over several years, mainly fueled by more enrollment and higher utilization around and after the pandemic.
Recent Trump administration federal budget bills have proposed large reductions for Medicaid, altering the program. The “One Big Beautiful Bill Act,” enacted in 2025, projects over $1 trillion in federal Medicaid cuts within the next decade, adds work requirements and increases cost-sharing—potentially limiting both coverage and funding for some people. Such changes are likely to transfer greater costs to state governments and slow the federal Medicaid growth rate while tens of millions continue to rely on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $32,472 | 2.2% |
| 2021 | $34,260 | 5.5% |
| 2022 | $33,841 | -1.2% |
| 2023 | $33,726 | -0.3% |
| 2024 | $35,680 | 5.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $1,988,093 | 59.2% |
| 2 | Medicine Services and Procedures | $462,571 | 13.8% |
| 3 | Ambulance and Other Transport Services and Supplies | $367,014 | 10.9% |
| 4 | Pathology and Laboratory Procedures | $289,512 | 8.6% |
| 5 | Dental Services | $138,459 | 4.1% |
| 6 | Radiology Procedures | $54,857 | 1.6% |
| 7 | Vision Services | $35,680 | 1.1% |
| 8 | Administrative, Miscellaneous and Investigational | $18,215 | 0.5% |
| 9 | Drugs Administered Other than Oral Method | $3,391 | 0.1% |
| 10 | Surgery | $327 | <0.1% |
| 11 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| V2784 | Lens polycarb or equal | $20,878 | 36 |
| V2020 | Vision svcs frames purchases | $10,750 | 39 |
| V2103 | Spherocylindr 4.00d/12-2.00d | $2,474 | 10 |
| V2100 | Lens spher single plano 4.00 | $1,577 | 10 |
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.
