According to the U.S. Department of Health and Human Services Medicaid Provider Spending database, Medicaid providers in Cape Coral billed $9,401,997 for Alcohol and Drug Abuse Treatment services in 2024. That reflected a 208.9% increase from 2023, when claims for the same category totaled $3,043,808.
Medicaid, a public insurance program overseen by states and funded through a partnership between state and federal governments, offers coverage to low-income families and individuals, including seniors, children, and people with disabilities. The program accounts for a major share of the U.S. health system.
Because Medicaid funding relies on taxpayers, changes in how services are billed locally reveal patterns in the distribution of public health care funding in the area.
The Alcohol and Drug Abuse Treatment category includes a group of Medicaid-billed services defined by type of care, using standardized HCPCS and CPT code sets. In compiling this analysis, each billing code was assigned to a single service category by consistent code prefixes and numbers, allowing accurate year-to-year comparisons while preventing double counting.
Alcohol and Drug Abuse Treatment was the third-largest category by Medicaid payments in Cape Coral in 2024, among multiple service categories that saw higher spending.
Statewide, Alcohol and Drug Abuse Treatment was the fourth-largest category for Medicaid payments in Florida for 2024.
Between 2019 and 2024, Cape Coral saw Medicaid payments for the Alcohol and Drug Abuse Treatment category increase by $9,242,296, or 5787.2%. Certain periods, notably in 2021 and 2023, showed rapid growth in spending.
Although these Medicaid payments were distributed across Cape Coral, most were concentrated in a few ZIP codes. In 2024, the highest Medicaid payments tied to Alcohol and Drug Abuse Treatment were reported in ZIP codes 33990 ($4,844,035), 33904 ($4,369,075), and 33909 ($188,884). Combined, these 3 ZIP codes represented 100% of Cape Coral’s Medicaid spending for this service category in 2024.
Within this treatment group, Medicaid payments remained focused on a small subset of billing codes.
To compare trends, Medicaid payments for Alcohol and Drug Abuse Treatment in Cape Coral grew by 208.9% from 2023 to 2024, whereas overall Medicaid claim categories in the city recorded a 21.8% change across the same timeframe.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending totaled about $871.7 billion nationwide in fiscal year 2023, making up around 18% of all U.S. health expenditures, up from approximately $613.5 billion in 2019, before the COVID-19 pandemic.
The increase amounts to roughly 40% growth in a few years, mainly due to expanded Medicaid enrollment and greater usage since the pandemic.
Federal budget measures enacted during the Trump administration, including the “One Big Beautiful Bill Act,” passed in 2025, are expected to reduce federal Medicaid spending by over $1 trillion over 10 years. The legislation adds provisions such as work requirements and higher cost-sharing, projected to limit coverage and reduce funding for certain participants. These shifts are likely to place greater financial responsibility on states and curb federal support as Medicaid remains a vital resource for millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $159,701 | 82.1% |
| 2021 | $1,430,932 | 796% |
| 2022 | $1,186,093 | -17.1% |
| 2023 | $3,043,808 | 156.6% |
| 2024 | $9,401,996 | 208.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $11,846,522 | 31.2% |
| 2 | National Codes Established for State Medicaid Agencies | $10,003,713 | 26.4% |
| 3 | Alcohol and Drug Abuse Treatment | $9,401,996 | 24.8% |
| 4 | Medicine Services and Procedures | $3,571,875 | 9.4% |
| 5 | Evaluation and Management | $1,582,275 | 4.2% |
| 6 | Procedures / Professional Services | $561,461 | 1.5% |
| 7 | Radiology Procedures | $351,854 | 0.9% |
| 8 | Dental Services | $250,227 | 0.7% |
| 9 | Pathology and Laboratory Procedures | $141,989 | 0.4% |
| 10 | Orthotic Procedures and services | $84,267 | 0.2% |
| 11 | Surgery | $77,800 | 0.2% |
| 12 | Administrative, Miscellaneous and Investigational | $43,178 | 0.1% |
| 13 | Drugs Administered Other than Oral Method | $30,619 | 0.1% |
| 14 | Temporary Codes | $3,384 | <0.1% |
| 15 | Vision Services | $1,495 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H2017 | Psysoc rehab svc, per 15 min | $8,673,648 | 88 |
| H2019 | Ther behav svc, per 15 min | $633,401 | 49 |
| H0032 | Mh svc plan dev by non-md | $54,658 | 31 |
| H0031 | Mh health assess by non-md | $40,288 | 33 |
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.
