In 2024, Rock Hill Medicaid providers billed $186,762 for Administrative, Miscellaneous and Investigational services, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. That amount reflects a 1319.5% surge from 2023, when claims for the same service type reached $13,157.
Medicaid is a state-administered public health insurance program funded jointly by federal and state governments. Its coverage extends to low-income individuals, families, seniors, children and people with disabilities, making it a core component of the U.S. health care system.
Since Medicaid payments draw from taxpayer resources, shifts in local billing volumes reflect changing allocations of public health care dollars at the community level.
The “Administrative, Miscellaneous and Investigational” group covers Medicaid-billed services defined by care type, using standard HCPCS and CPT code groupings. Each billing code in this analysis was matched to a single category through uniform code prefixes and numeric ranges, enabling comparability and ranking accuracy while preventing double counting.
While various Medicaid service categories saw spending increases, Administrative, Miscellaneous and Investigational ranked 14th in Rock Hill by total Medicaid payments in 2024.
Statewide in South Carolina, the Administrative, Miscellaneous and Investigational category placed 17th by total Medicaid payments during 2024.
Between 2019 and 2024, Medicaid payments tied to the Administrative, Miscellaneous and Investigational category in Rock Hill rose by $143,839, or 335.1%. This growth accelerated at points, with substantial year-over-year increases noted in both 2022 and 2023.
While spending on Administrative, Miscellaneous and Investigational care occurred throughout Rock Hill, the majority of payments came from a small number of ZIP codes. In 2024, ZIP code 29732 recorded $186,761 in associated Medicaid payments. The top ZIP code represented 100% of Medicaid payments within this category in Rock Hill for the year.
Medicaid payments in the Administrative, Miscellaneous and Investigational category were also highly concentrated within a few specific billing codes.
In comparison, Medicaid payments for Administrative, Miscellaneous and Investigational services in Rock Hill grew 1319.5% between 2023 and 2024, whereas all Medicaid claim categories in the city rose by 9.9% during the same period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures totaled approximately $871.7 billion in fiscal year 2023, or about 18% of national health spending, up from around $613.5 billion in 2019, which was before the COVID-19 pandemic.
This marks nearly 40% growth over several years, as expanded enrollment and increased utilization drove costs higher during and following the pandemic.
Recent federal budget acts under the Trump administration have proposed large reductions in federal Medicaid funding and changes to the structure of the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is projected to cut federal Medicaid spending by more than $1 trillion over 10 years, including new policies such as work requirements and greater cost-sharing that may reduce coverage and funding for some participants. These measures are expected to shift more financial responsibility to states and constrain the expansion of federal support, even as Medicaid continues to serve tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $42,922 | -29.2% |
| 2021 | $38,354 | -10.6% |
| 2022 | $49,114 | 28.1% |
| 2023 | $13,156 | -73.2% |
| 2024 | $186,761 | 1319.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $8,796,038 | 30.8% |
| 2 | Evaluation and Management | $7,543,867 | 26.4% |
| 3 | Medicine Services and Procedures | $4,998,696 | 17.5% |
| 4 | Pathology and Laboratory Procedures | $1,759,449 | 6.2% |
| 5 | Dental Services | $1,086,921 | 3.8% |
| 6 | Drugs Administered Other than Oral Method | $906,831 | 3.2% |
| 7 | Procedures / Professional Services | $706,013 | 2.5% |
| 8 | Alcohol and Drug Abuse Treatment | $558,270 | 2% |
| 9 | Temporary National Codes (Non-Medicare) | $336,326 | 1.2% |
| 10 | Surgery | $312,085 | 1.1% |
| 11 | Radiology Procedures | $274,510 | 1% |
| 12 | Ambulance and Other Transport Services and Supplies | $271,576 | 1% |
| 13 | Coronavirus Diagnostic Panel | $205,338 | 0.7% |
| 14 | Administrative, Miscellaneous and Investigational | $186,761 | 0.7% |
| 15 | Temporary Codes | $183,285 | 0.6% |
| 16 | Medical And Surgical Supplies | $182,244 | 0.6% |
| 17 | Durable Medical Equipment | $132,805 | 0.5% |
| 18 | Outpatient PPS | $75,360 | 0.3% |
| 19 | Vision Services | $41,716 | 0.1% |
| 20 | Chemotherapy Drugs | $10,035 | <0.1% |
| 21 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $2,420 | <0.1% |
| 22 | Orthotic Procedures and services | $1,299 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| A9150 | Misc/exper non-prescript dru | $186,260 | 11 |
| A9585 | Gadobutrol injection | $500 | 2 |
| A9270 | Non-covered item or service | $0 | 11 |
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.
