South Dakota Medicaid billing for Administrative, Miscellaneous and Investigational services reaches $1,019,523 in 2024

Statewide Medicaid payments in South Dakota for services listed as Administrative, Miscellaneous and Investigational reached $1,019,523 in 2024, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 52% jump compared with 2023, when providers filed claims totaling $670,696.

Medicaid serves as a public health insurance initiative, administered by states and funded through both federal and state resources. The program covers low-income individuals and families, seniors, children and people with disabilities, making it one of the largest components of the U.S. health system.

Because Medicaid is taxpayer-funded, shifts in billing activity reflect how public health care expenditures are distributed at the local level.

The “Administrative, Miscellaneous and Investigational” service category includes a range of Medicaid claims classified by care type, using standardized HCPCS and CPT coding systems. For this report, each code was assigned to a single category using established code prefixes and number ranges, grouping related services for analysis and preventing double counting to maintain consistent rankings over time.

Categories such as these often encompass different types of care. When applicable, these groupings bring together related services like office appointments, diagnostic work, and therapeutic procedures that are typically billed together under Medicaid.

In the five years before 2024, payments for this category in South Dakota went up by $817,349, or 404.3%. Some periods saw spending accelerate, with substantial gains year over year in 2021 and 2022.

Payments for Administrative, Miscellaneous and Investigational services were distributed throughout the state, but a few ZIP codes saw the majority of spending. In 2024, leading ZIP codes included 57105 with $304,235 (29.8% of the total), 57107 with $250,439 (24.6%), and 57783 with $174,687 (17.1%).

The top three ZIP codes combined made up 71.5% of all Medicaid spending for this service category in 2024.

By comparison, Medicaid claims across all categories in South Dakota rose 17.4% from 2023 to 2024.

Although payments rose in multiple categories, Administrative, Miscellaneous and Investigational services placed among the 16 largest service categories statewide based on total payments in 2024.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures amounted to about $871.7 billion in fiscal year 2023, making up nearly 18% of national health spending. This was a sharp increase from around $613.5 billion in 2019, before the COVID-19 pandemic.

This growth marks an approximate 40% rise over a few years, mainly due to greater enrollment and increased health service usage during and after the pandemic.

More recent federal budget actions under the Trump administration have brought significant proposals for changes to Medicaid. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid funding by over $1 trillion in the next decade, with new work requirements and cost-sharing rules that could lower coverage and state funding for some recipients. These provisions are projected to shift more expenses onto states and cap the expansion of federal funding, even as Medicaid continues to assist tens of millions of Americans.