Sweetwater Medicaid payments for national codes rise to $363,612 in 2024

In 2024, Medicaid providers in Sweetwater submitted claims totaling $363,612 for services classified 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 figure represents a 303.4% increase over the $90,132 in claims submitted in 2023 for the same service group.

Medicaid, which is administered at the state level and funded by both federal and state governments, provides health coverage to people who have low incomes, as well as seniors, children, and individuals with disabilities. It is one of the largest parts of the U.S. health care system.

Fluctuations in local Medicaid billing reflect how publicly funded health care dollars are distributed within a community.

The “National Codes Established for State Medicaid Agencies” service group covers Medicaid billing for a range of services defined by standardized HCPCS and CPT code sets. For this study, each billing code was categorized based on consistent prefixes and number ranges, combining similar services for analysis while avoiding duplicated claims and maintaining accurate rankings over time.

This category ranked third for Medicaid payments by service group in Sweetwater for 2024, following growth in several other major categories.

At the state level, National Codes Established for State Medicaid Agencies secured the top position in Tennessee for total Medicaid payments in 2024.

Reviewing the five-year period through 2024, Medicaid payments connected to this category in Sweetwater increased $182,571, or 100.8%. Notable jumps were seen year over year in 2023 and 2022, indicating accelerating growth during certain segments of the period.

Payments within the National Codes Established for State Medicaid Agencies group spanned the city but were heavily concentrated in a small number of ZIP codes. For 2024, ZIP code 37874 represented nearly all reported Medicaid payments in this category, accounting for $363,611. Altogether, the top ZIP code comprised 100% of payments attributed to this category in Sweetwater for the year.

A majority of Medicaid dollars within this group were attributed to a small subset of billing codes.

To illustrate the increase, Medicaid payments tied to this group of national billing codes were up 303.4% between 2024 and 2023 in Sweetwater, compared to an overall 19.4% increase for all Medicaid claim categories citywide during that time.

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

This rise amounts to around 40% growth within a few years, primarily due to expanded enrollment and greater service usage following the pandemic.

Recently passed federal budget laws from the Trump administration included measures to scale back federal Medicaid funding and modify program rules. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to cut more than $1 trillion from federal Medicaid spending over 10 years through added work and cost-sharing requirements. These measures could result in reduced funding and coverage for some Medicaid beneficiaries, shifting additional costs to states while federal support for the safety-net program slows even as it continues to cover 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.