In 2024, providers in Spring City billed $1,724,959 to Medicaid for services in the National Codes Established for State Medicaid Agencies category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This represented a 35.1% rise from 2023, when claims for this category totaled $1,276,791.
Medicaid, a public health insurance initiative administered at the state level and financed jointly by federal and state governments, provides coverage for low-income populations, seniors, children, and those with disabilities. It remains a significant component of the overall U.S. health care framework.
Because taxpayer dollars fund Medicaid payments, changes in local billing highlight how health care resources are distributed within the community.
The “National Codes Established for State Medicaid Agencies” group consists of specific Medicaid-billed services categorized by the type of care delivered, using standardized HCPCS and CPT code ranges. Each service code for this report was assigned to a single category based on prefix and numbering standards, enabling consistent comparison without double counting and supporting accurate rankings over time.
National Codes Established for State Medicaid Agencies saw the highest total Medicaid payments in Spring City in 2024 among all service categories, with overall Medicaid spending also rising across other areas.
Statewide, National Codes Established for State Medicaid Agencies also ranked first for total Medicaid payments in Tennessee in 2024.
From 2019 through 2024, Spring City experienced a $689,173, or 66.5%, increase in Medicaid payments for the National Codes Established for State Medicaid Agencies category. The pace of spending gains grew faster in some periods, notably in 2020 and 2021, with notable year-over-year increases.
Although spending in this category occurred throughout Spring City, a small number of ZIP codes accounted for the majority of payments. In 2024, ZIP code 37381 recorded Medicaid payments totaling $1,724,958 in this category. The top ZIP code made up 100% of all category payments in the city for the year.
Within the National Codes Established for State Medicaid Agencies category, most Medicaid payments were concentrated among a select group of individual service codes.
Between 2024 and 2023, Medicaid payments for this category in Spring City grew by 35.1%, outpacing the 24.6% increase seen across all Medicaid payment categories citywide during the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures reached about $871.7 billion in the 2023 fiscal year, making up approximately 18% of total national health spending. This was a substantial jump from $613.5 billion in 2019, prior to the COVID-19 pandemic.
The change amounts to nearly 40% growth in just several years, mainly driven by expanded coverage and increased use of services during and following the pandemic.
Recent federal budget measures under the Trump administration have introduced significant changes to Medicaid, including plans to scale back federal funding and rework the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid funding by more than $1 trillion over 10 years, along with policy adjustments such as work requirements and higher cost-sharing. These changes could result in reduced coverage and increased state financial responsibility, despite the program’s role in supporting tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,035,786 | 823.7% |
| 2021 | $1,437,138 | 38.7% |
| 2022 | $983,029 | -31.6% |
| 2023 | $1,276,791 | 29.9% |
| 2024 | $1,724,958 | 35.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $1,724,958 | 89% |
| 2 | Evaluation and Management | $174,758 | 9% |
| 3 | Pathology and Laboratory Procedures | $31,930 | 1.6% |
| 4 | Medicine Services and Procedures | $5,669 | 0.3% |
| 5 | Vision Services | $319 | <0.1% |
| 6 | Surgery | $32 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2033 | Res, nos waiver per diem | $1,607,583 | 10 |
| T2016 | Habil res waiver per diem | $117,374 | 1 |
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.
