Gatlinburg Medicaid spending on pathology and lab services rises 105% to $15,611 in 2024

Gatlinburg Medicaid providers submitted $15,611 in 2024 for services under the Pathology and Laboratory Procedures category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 105.3% jump from 2023, when claims totaled $7,603 for the same services.

Medicaid, administered by states but funded jointly at state and federal levels, covers seniors, children, people with disabilities, and low-income individuals and families, making it a key part of the U.S. health system.

Adjustments in Medicaid billing locally reflect how taxpayer funding for health care is distributed within each community.

The “Pathology and Laboratory Procedures” group includes services billed under standardized HCPCS and CPT codes. In this analysis, each code was matched to a single service category using uniform code prefixes and ranges, allowing grouped review of related services while maintaining accurate rankings and preventing double counting over time.

While Medicaid expenses grew in several categories, Pathology and Laboratory Procedures ranked second by total Medicaid payments in Gatlinburg in 2024.

Statewide in Tennessee, the Pathology and Laboratory Procedures group placed sixth in overall payments in 2024.

During the five years before 2024, Medicaid payments for Pathology and Laboratory Procedures in Gatlinburg grew by $8,532, an increase of 120.5%. Growth in spending accelerated at certain points, with sizable annual increases seen in 2022 and 2023.

Although this category’s spending was geographically dispersed, payments in 2024 were mainly concentrated in a few ZIP codes. ZIP code 37738 accounted for $15,610 of these Medicaid payments, representing 100% of the city’s total for this type of service in 2024.

Most Medicaid spending within Pathology and Laboratory Procedures was tied to a smaller subset of specific billing codes.

To compare, between 2024 and 2023, Medicaid payments for Pathology and Laboratory Procedures in Gatlinburg went up 105.3%, while all Medicaid claim categories in the city increased by 33.2% over the same period.

According to the Centers for Medicare & Medicaid Services, Medicaid spent approximately $871.7 billion nationwide in fiscal year 2023, making up around 18% of all U.S. health care expenditures. That was a substantial rise from about $613.5 billion in 2019, prior to the COVID-19 pandemic.

This surge—roughly 40% within several years—was mainly attributed to increased enrollment and higher service use during and following the pandemic.

Recent budget measures in the Trump administration brought major proposals affecting Medicaid’s federal funding structure. The “One Big Beautiful Bill Act,” enacted in 2025, is forecasted to cut more than $1 trillion in federal Medicaid funding over the next 10 years. It introduces new requirements like work and increased cost-sharing, potentially reducing funding and coverage for some recipients. These changes are poised to shift financial responsibility to states and reduce federal Medicaid growth while the program continues to support tens of millions of people in the U.S.

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.