Dover Medicaid providers submitted $639,831 in claims for Vision Services in 2024, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 2.2% increase from 2023, when $625,971 in claims were submitted for the same category.
Medicaid, a public health insurance program jointly funded by federal and state governments, is administered by individual states and covers low-income families and individuals, seniors, children, and those with disabilities, making it a significant part of the U.S. health care system.
Since Medicaid payments are sourced from taxpayers, fluctuations in local billing reflect how community public health care resources are distributed.
The Vision Services category includes a group of Medicaid-billed services organized by type of care, segmented according to standardized HCPCS and CPT code groupings. In this analysis, each billing code was assigned to one service group, using consistent code prefixes and number ranges. This methodology ensures related services are grouped for analysis without double counting, helping maintain accurate tracking over time.
Although Medicaid disbursements rose in multiple service categories, Vision Services ranked 10th by total Medicaid payments in Dover in 2024.
Statewide in Delaware, Vision Services was the 14th largest Medicaid payment category for 2024.
Over the five years leading to 2024, Medicaid expenditures tied to Vision Services in Dover climbed by $521,234, representing a 439.5% increase. Some periods saw faster growth, particularly in 2022 and 2021, with noticeable year-over-year spending gains.
Payments for services in the Vision Services category were not evenly spread across Dover. In 2024, ZIP code 19904 accounted for $639,831, which represented 100% of all Medicaid payments for Vision Services in the area during the year.
When it comes to specific procedures, a small group of billing codes made up most Vision Services Medicaid claims in the city.
Between 2024 and 2023, Medicaid Vision Services claims in Dover rose by 2.2%, while citywide claims across all Medicaid categories saw a 28.1% change over the same period.
According to the Centers for Medicare & Medicaid Services, total Medicaid spending by federal and state governments reached about $871.7 billion in fiscal year 2023, representing nearly 18% of national health expenditures, up from around $613.5 billion in 2019, before the COVID-19 crisis.
This amounts to close to 40% growth within just a few years, mainly driven by expanded enrollment and increased service use during and after the pandemic.
Recent federal budget actions taken during the Trump administration have included substantial proposals to reduce federal Medicaid funding and modify how the program operates. The “One Big Beautiful Bill Act,” signed in 2025, is anticipated to slash federal Medicaid expenditures by more than $1 trillion over the next decade. The law introduces policies such as work requirements and raised cost-sharing, which may decrease coverage and available funding for some Medicaid beneficiaries. These measures are projected to shift greater costs to the states and limit the future growth of federal support, even as the program continues to serve millions across America.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $118,597 | -0.4% |
| 2021 | $196,277 | 65.5% |
| 2022 | $711,166 | 262.3% |
| 2023 | $625,971 | -12% |
| 2024 | $639,831 | 2.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $22,166,500 | 44.7% |
| 2 | Evaluation and Management | $11,848,745 | 23.9% |
| 3 | Medicine Services and Procedures | $3,003,983 | 6.1% |
| 4 | National Codes Established for State Medicaid Agencies | $2,887,670 | 5.8% |
| 5 | Alcohol and Drug Abuse Treatment | $2,833,868 | 5.7% |
| 6 | Pathology and Laboratory Procedures | $1,416,989 | 2.9% |
| 7 | Radiology Procedures | $1,304,139 | 2.6% |
| 8 | Dental Services | $1,090,399 | 2.2% |
| 9 | Surgery | $924,812 | 1.9% |
| 10 | Vision Services | $639,831 | 1.3% |
| 11 | Drugs Administered Other than Oral Method | $521,269 | 1.1% |
| 12 | Procedures / Professional Services | $513,425 | 1% |
| 13 | Anesthesia | $234,410 | 0.5% |
| 14 | Temporary Codes | $118,616 | 0.2% |
| 15 | Ambulance and Other Transport Services and Supplies | $23,381 | <0.1% |
| 16 | Hearing Services | $6,298 | <0.1% |
| 17 | Administrative, Miscellaneous and Investigational | $2,199 | <0.1% |
| 18 | Medical And Surgical Supplies | $0 | <0.1% |
| 18 | Screening Procedures | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| V2100 | Lens spher single plano 4.00 | $261,672 | 33 |
| V2020 | Vision svcs frames purchases | $185,736 | 36 |
| V2200 | Lens spher bifoc plano 4.00d | $61,387 | 19 |
| V2784 | Lens polycarb or equal | $50,448 | 12 |
| V2103 | Spherocylindr 4.00d/12-2.00d | $31,036 | 27 |
| V2520 | Contact lens hydrophilic | $23,883 | 11 |
| V2521 | Cntct lens hydrophilic toric | $19,025 | 9 |
| V2203 | Lens sphcyl bifocal 4.00d/.1 | $6,641 | 5 |
| V2632 | Post chmbr intraocular lens | $0 | 4 |
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.
