In 2024, Medicaid providers in Charleston submitted $432,778 in claims for Dental Services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents a 63% rise compared with 2023, when claims for these services totaled $265,530.
Medicaid is a state-run public health insurance program supported by both federal and state governments. The program provides coverage for low-income residents, seniors, children, and individuals with disabilities, representing a significant component of the U.S. health care system.
Since Medicaid is funded through taxpayer dollars, shifts in local provider billing show how health care resources are dispersed within communities.
The “Dental Services” group covers services defined by the type of care, using established HCPCS and CPT code lists. For this report, each service code was assigned to a specific category through consistent prefix and code range mapping, ensuring related procedures are reviewed together, reducing duplicates, and maintaining proper rankings over time.
Though spending rose in multiple service areas, Dental Services stood at 14th place by Medicaid payments in Charleston in 2024.
Statewide, the Dental Services category was 13th among all service types in West Virginia for same-year Medicaid payments.
Charleston’s Medicaid spending for Dental Services increased by $63,990, or 17.4%, in the five years before 2024. Notably, distinct yearly jumps occurred in 2020 and 2022.
While Medicaid spending on Dental Services was spread throughout Charleston, a majority was concentrated in certain ZIP codes. In 2024, ZIP code 25301 saw $240,082, 25302 had $64,032, and 25314 recorded $43,074. Collectively, these top 3 ZIP codes comprised 80.2% of all Medicaid Dental Services payments citywide for the year.
Most Medicaid-funded Dental Services activity was associated with a limited subset of specific billing codes.
Between 2024 and 2023, Medicaid payments tied to Dental Services in Charleston rose by 63%, while all Medicaid claim categories in the city together increased by 18.4% for that period.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending reached approximately $871.7 billion in fiscal year 2023, making up close to 18% of the nation’s total health spending and rising from about $613.5 billion in 2019, before the COVID-19 crisis.
This marks an increase of about 40% in several years, with much of that rise attributed to expanded enrollment and more frequent provider use during and following the pandemic.
Recent federal budget law from the Trump administration included major initiatives to lower federal Medicaid spending and change how the program is structured. For example, the “One Big Beautiful Bill Act,” which became law in 2025, is projected to reduce federal Medicaid funding by over $1 trillion over the next ten years. The legislation introduces new rules like work requirements and more out-of-pocket costs that could affect access and available funds for some Medicaid recipients. These policies will likely require states to carry a larger share of Medicaid costs and could curb the program’s future federal growth, yet Medicaid continues to support tens of millions of people nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $368,787 | 43.6% |
| 2021 | $311,845 | -15.4% |
| 2022 | $328,401 | 5.3% |
| 2023 | $265,530 | -19.1% |
| 2024 | $432,778 | 63% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Pathology and Laboratory Procedures | $40,976,151 | 27.6% |
| 2 | Alcohol and Drug Abuse Treatment | $22,309,219 | 15.1% |
| 3 | Evaluation and Management | $20,715,238 | 14% |
| 4 | Medicine Services and Procedures | $19,313,003 | 13% |
| 5 | National Codes Established for State Medicaid Agencies | $13,658,663 | 9.2% |
| 6 | Ambulance and Other Transport Services and Supplies | $9,146,434 | 6.2% |
| 7 | Procedures / Professional Services | $8,176,031 | 5.5% |
| 8 | Temporary National Codes (Non-Medicare) | $5,295,393 | 3.6% |
| 9 | Radiology Procedures | $2,128,969 | 1.4% |
| 10 | Surgery | $2,076,027 | 1.4% |
| 11 | Drugs Administered Other than Oral Method | $1,333,091 | 0.9% |
| 12 | Anesthesia | $1,066,612 | 0.7% |
| 13 | Durable Medical Equipment | $467,464 | 0.3% |
| 14 | Dental Services | $432,778 | 0.3% |
| 15 | Enteral and Parenteral Therapy | $331,030 | 0.2% |
| 16 | Vision Services | $270,844 | 0.2% |
| 17 | Administrative, Miscellaneous and Investigational | $127,426 | 0.1% |
| 18 | Chemotherapy Drugs | $120,724 | 0.1% |
| 19 | Medical And Surgical Supplies | $105,400 | 0.1% |
| 20 | Orthotic Procedures and services | $87,258 | 0.1% |
| 21 | Temporary Codes | $23,684 | <0.1% |
| 22 | Outpatient PPS | $19,054 | <0.1% |
| 23 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $15,016 | <0.1% |
| 24 | Coronavirus Diagnostic Panel | $4,307 | <0.1% |
| 25 | Other Services | $0 | <0.1% |
| 25 | Pathology and Laboratory Services | $0 | <0.1% |
| 25 | Screening Procedures | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| D0330 | Panoramic image | $63,750 | 43 |
| D0340 | 2d cephalometric image | $58,141 | 16 |
| D0140 | Limit oral eval problm focus | $55,771 | 64 |
| D0150 | Comprehensve oral evaluation | $55,632 | 57 |
| D0120 | Periodic oral evaluation | $51,300 | 67 |
| D0470 | Diagnostic casts | $33,658 | 15 |
| D0210 | Intraor comprehensive series | $32,731 | 25 |
| D0274 | Bitewings four images | $18,484 | 27 |
| D0350 | Oral/facial photo images | $17,840 | 16 |
| D0220 | Intraoral periapical first | $17,117 | 42 |
| D0250 | Extraoral 2d project image | $14,027 | 12 |
| D0272 | Dental bitewings two images | $8,851 | 14 |
| D0230 | Intraoral periapical ea add | $5,214 | 13 |
| D0240 | Intraoral occlusal film | $257 | 1 |
| D0601 | Caries risk assess low risk | $0 | 1 |
| D0603 | Caries risk assess high risk | $0 | 1 |
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.
