Gainesville Medicaid payments for National Codes Established for State Medicaid Agencies reach $2,600,860 in 2024

Gainesville providers submitted $2,600,860 in Medicaid claims for services under the National Codes Established for State Medicaid Agencies in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. That total reflects a 4.1% rise over 2023, when claims for the same services amounted to $2,497,600.

Medicaid, a state-administered public health insurance program backed by both federal and state funding, offers coverage for low-income families, individuals, seniors, children, and people with disabilities, making it a central component of U.S. health care.

Because Medicaid is funded by taxpayers, shifts in local claim amounts reveal how public health care resources are allocated in a community.

The “National Codes Established for State Medicaid Agencies” group encompasses Medicaid services identified by types of care, organized by standard HCPCS and CPT code sets. For this study, billing codes were grouped into service categories using systematic code prefixes and numeric ranges, enabling related services to be analyzed collectively while avoiding duplicate counts and preserving accurate rankings over time.

While growth occurred in several Medicaid service categories, National Codes Established for State Medicaid Agencies held the second spot for total Medicaid payments in Gainesville for 2024.

Statewide in Virginia, this service category ranked first by total Medicaid payments during 2024.

Between 2019 and 2024, Medicaid payments for the National Codes Established for State Medicaid Agencies category in Gainesville climbed by $2,505,136, marking an increase of 2617.1%. Periods of faster spending growth were observed, notably in 2022 and 2023.

Although services in the National Codes Established for State Medicaid Agencies category were delivered across the city, most Medicaid payments were concentrated in a small number of ZIP codes. In 2024, ZIP code 20155 accounted for $2,600,859 of Medicaid payments, representing 100% of the city’s total payments for this category that year.

Payments within this category were also concentrated in a small set of billing codes.

Comparing year-over-year shifts, Medicaid payments in Gainesville connected to National Codes Established for State Medicaid Agencies grew by 4.1% between 2024 and 2023. In comparison, all Medicaid claim categories in Gainesville saw a 14.4% change during that period.

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

This growth represents about a 40% increase over a few years, primarily due to rising enrollment and increased use of Medicaid services during and following the pandemic.

The Trump administration’s recent federal budget legislation contained several major proposals to reduce Medicaid’s federal funding and restructure the program. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid spending by more than $1 trillion over 10 years. It also introduces new requirements—including work mandates and greater cost-sharing—which could limit coverage and resources for some enrollees. These measures are likely to shift additional expenses to states and slow growth in federal Medicaid support as the program continues serving tens of millions across the country.

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.