Medicaid payments for National Codes Established for State Medicaid Agencies reach $1.5 million in North Richmond for 2024

In 2024, Medicaid providers in North Richmond billed $1,524,287 for services listed under the National Codes Established for State Medicaid Agencies category, based on records from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflected an 8.8% increase over 2023, when $1,401,561 in claims were submitted for comparable services.

Medicaid, a joint initiative between state and federal governments, is a public health insurance program that serves low-income populations, seniors, children, and individuals with disabilities. It is a major component of health care coverage in the United States. More information is available about how the program is funded at the Commonwealth Fund.

Fluctuations in Medicaid billing help illustrate the distribution of public health care resources in specific communities, as the program relies on taxpayer funding.

The “National Codes Established for State Medicaid Agencies” category encompasses a selection of Medicaid services categorized by care type and defined by standardized HCPCS and CPT coding systems. To ensure accuracy, each code was grouped under a single service category based on code prefixes and number ranges, which helps track related services over time without duplication in analysis or rankings.

Although total Medicaid spending in North Richmond increased across several service groups, the National Codes Established for State Medicaid Agencies category led all others in payment amounts for 2024.

Statewide in California, the National Codes Established for State Medicaid Agencies category also carried the highest total Medicaid payment in 2024.

During the five-year span through 2024, North Richmond’s Medicaid payments for the National Codes Established for State Medicaid Agencies category climbed by $405,451, marking a 21% increase. Some years, such as 2020 and 2021, posted stronger year-over-year growth within this category.

Spending for this category in North Richmond was most concentrated within a small number of ZIP codes. In 2024, ZIP code 94801 was the top contributor, accounting for $1,524,286—representing 100% of Medicaid payments for the category in North Richmond for the year.

Medicaid disbursements within the National Codes Established for State Medicaid Agencies category were also focused on a handful of specific billing codes.

Payments in this category jumped 8.8% from 2023 to 2024 in North Richmond, a change that slightly outpaced the 8.5% rise reported for all Medicaid claim categories in the city during the same time frame.

Centers for Medicare & Medicaid Services data show federal and state Medicaid spending together reached approximately $871.7 billion for the 2023 fiscal year, making up about 18% of all national health expenses and rising sharply from the $613.5 billion spent in 2019 before the COVID-19 pandemic.

The roughly 40% increase in spending over this period was chiefly due to greater enrollment and increased utilization during and after the pandemic.

Federal budget measures enacted during the Trump administration introduced major proposals to trim federal Medicaid funding and change the structure of the program. The “One Big Beautiful Bill Act,” passed in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the coming decade while introducing requirements like work mandates and expanded cost-sharing. These measures may reduce coverage and federal funding for certain groups, shifting financial responsibility to states as the program covers 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.