In 2024, Medicaid providers in Cleveland billed a total of $7,638,970 for services in the National Codes Established for State Medicaid Agencies category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents an increase of 661.3% compared with 2023 figures, when providers submitted $1,003,475 in claims for these services.
Medicaid, a government-run health insurance program managed at the state level and financed by both federal and state sources, provides coverage for low-income individuals and families, seniors, children, and people with disabilities—making it a significant part of the U.S. health care system.
Because taxpayer dollars fund Medicaid payments, variations in local billing levels reflect how health care resources are allocated in neighborhoods.
The “National Codes Established for State Medicaid Agencies” grouping is defined by distinct Medicaid service codes indicating the type of care rendered, structured under standardized HCPCS and CPT classifications. For this analysis, each code was mapped to a unique service category using consistent prefixes and number ranges, ensuring combined reporting for related services while avoiding duplicate counts and maintaining valid trend rankings.
Among all service categories, National Codes Established for State Medicaid Agencies drew the highest total Medicaid payments in Cleveland during 2024.
At the state level, Tennessee also saw the National Codes Established for State Medicaid Agencies category lead all others by total payments in 2024.
Between 2019 and 2024, Medicaid payments for this category in Cleveland saw an increase of $6,230,675, or 442.4%. Certain years, such as 2020 and 2023, witnessed accelerated year-over-year spending growth.
Within Cleveland, while overall spending for National Codes Established for State Medicaid Agencies was documented citywide, the majority of payments were concentrated in a small set of ZIP codes. In 2024, ZIP code 37364 reported $6,038,108 in Medicaid payments, 37312 recorded $1,483,047, and 37311 had $117,814. These 3 ZIP codes collectively accounted for 100% of all Medicaid payments related to this category in Cleveland for the year.
Payments in this category also tended to cluster among a small number of individual Medicaid billing codes.
Comparatively, Medicaid payments linked to the category in Cleveland rose by 661.3% from 2023 to 2024, while all Medicaid claim categories in the city increased 27.7% over the same timeframe.
According to the Centers for Medicare & Medicaid Services, total Medicaid spending by federal and state sources amounted to about $871.7 billion during the 2023 fiscal year, representing around 18% of national health expenditures and increasing sharply from $613.5 billion in 2019, before the COVID-19 pandemic.
This marks an approximate 40% growth in a few years, primarily due to higher enrollment and increased usage during and following the pandemic.
Recent federal budget laws passed under the Trump administration have included notable measures to scale back federal Medicaid funding and alter the program’s structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid spending by more than $1 trillion over a decade and introduce work requirements and higher cost-sharing, which could impact access and funding for certain beneficiaries. These provisions are expected to shift fiscal responsibility to states and cap growth in federal Medicaid dollars, as the program continues to cover tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,408,295 | 64.6% |
| 2021 | $1,107,975 | -21.3% |
| 2022 | $724,416 | -34.6% |
| 2023 | $1,003,475 | 38.5% |
| 2024 | $7,638,970 | 661.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $7,638,970 | 37.2% |
| 2 | Evaluation and Management | $4,902,371 | 23.9% |
| 3 | Medicine Services and Procedures | $2,221,960 | 10.8% |
| 4 | Alcohol and Drug Abuse Treatment | $1,796,566 | 8.8% |
| 5 | Temporary National Codes (Non-Medicare) | $968,849 | 4.7% |
| 6 | Pathology and Laboratory Procedures | $953,531 | 4.6% |
| 7 | Ambulance and Other Transport Services and Supplies | $539,073 | 2.6% |
| 8 | Dental Services | $298,151 | 1.5% |
| 9 | Coronavirus Diagnostic Panel | $284,914 | 1.4% |
| 10 | Medical And Surgical Supplies | $212,433 | 1% |
| 11 | Surgery | $191,261 | 0.9% |
| 12 | Durable Medical Equipment | $162,111 | 0.8% |
| 13 | Radiology Procedures | $158,911 | 0.8% |
| 14 | Procedures / Professional Services | $93,676 | 0.5% |
| 15 | Vision Services | $67,248 | 0.3% |
| 16 | Drugs Administered Other than Oral Method | $23,444 | 0.1% |
| 17 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $5,409 | <0.1% |
| 18 | Administrative, Miscellaneous and Investigational | $1,435 | <0.1% |
| 19 | Orthotic Procedures and services | $507 | <0.1% |
| 20 | Temporary Codes | $9 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2033 | Res, nos waiver per diem | $4,182,055 | 5 |
| T1019 | Personal care ser per 15 min | $1,106,941 | 19 |
| T2021 | Day habil waiver per 15 min | $1,065,983 | 16 |
| T2025 | Waiver service, nos | $904,568 | 5 |
| T1017 | Targeted case management | $376,105 | 11 |
| T2002 | N-et; per diem | $3,315 | 3 |
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.
