Athens sees 1856.8% surge in Medicaid payments for National Codes Established for State Medicaid Agencies in 2024

In 2024, Medicaid providers in Athens billed $2,630,338 for services under the National Codes Established for State Medicaid Agencies category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represented an increase of 1856.8% from 2023, when $134,418 in claims were submitted for this service group.

Medicaid, a public health insurance program managed by states and financed in partnership by federal and state governments, covers low-income families and individuals, seniors, children, and those with disabilities, making it a central part of the U.S. health care system.

Because taxpayer dollars fund Medicaid payments, trends in local billing highlight how health care resources are distributed in the community.

The “National Codes Established for State Medicaid Agencies” category encompasses various Medicaid-billed services defined by the type of care delivered, using standardized HCPCS and CPT code groupings. For this report, billing codes were organized into a single service category based on prefixes and numeric ranges, allowing a comprehensive view of related services while preventing double counting and maintaining accuracy in rankings over time.

Medicaid outlays rose across multiple categories, but in Athens, National Codes Established for State Medicaid Agencies ranked second in total Medicaid payments for 2024.

Statewide in Tennessee, National Codes Established for State Medicaid Agencies took the top spot in total Medicaid payments for 2024.

Looking at the five years before 2024, Medicaid payments for the National Codes Established for State Medicaid Agencies category in Athens rose by $2,630,338, or 0%. Some years saw particularly strong growth, especially in 2023 and 2022.

While payments for this category were spread throughout Athens, they were heavily concentrated in a small group of ZIP codes. In 2024, ZIP code 37303 saw the highest Medicaid payments tied to the National Codes Established for State Medicaid Agencies category, totaling $2,630,337. All Medicaid payments for this category in Athens during the year came from this ZIP code.

Within the National Codes Established for State Medicaid Agencies category, a small number of individual billing codes made up most Medicaid payments.

For context, Medicaid payments in Athens for the National Codes Established for State Medicaid Agencies category rose 1856.8% from 2023 to 2024, whereas overall Medicaid claim categories in the city increased by 33.4% in that span.

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

This almost 40% rise over several years is mainly due to greater enrollment and utilization during and after the pandemic.

Recent federal budget changes under the Trump administration have brought major proposals to curb federal Medicaid funding and alter the program. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid spending by more than $1 trillion over 10 years and introduces measures like work requirements and increased cost-sharing, which may lower coverage and funds for some recipients. These shifts are expected to move more financial responsibility to states and constrain future federal Medicaid funding growth, though the program will still serve tens of millions of Americans.

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.