Coalport sees 83% surge in Medicaid payments for National Codes Established for State Medicaid Agencies in 2024

In 2024, Medicaid providers in Coalport billed $96,133 for services within the National Codes Established for State Medicaid Agencies, according to the U.S. Department of Health and Human Services Medicaid Provider Spending data. This represents an 82.8% rise from 2023, when claims for the same category totaled $52,590.

Medicaid, a major part of the U.S. health care system, is a public insurance initiative administered by states and funded through both federal and state resources. It serves individuals and families with low income, seniors, children, and those with disabilities.

Shifts in Medicaid billing levels reflect changes in local allocation of public health care resources, since payments draw from taxpayer funds.

The National Codes Established for State Medicaid Agencies category groups Medicaid-billed services defined by care type, using standardized HCPCS and CPT codes. In this analysis, each billing code was assigned exclusively to one service category, utilizing consistent prefixes and numeric ranges to group related services. This approach avoids double counting and maintains accurate time-based comparisons.

National Codes Established for State Medicaid Agencies led all Medicaid service categories in Coalport by total payment in 2024, even as spending climbed in several areas.

Across Pennsylvania, this service category was the second-highest by Medicaid payments during 2024.

Between 2019 and 2024, Medicaid payments for this category in Coalport climbed by $55,705, a 137.8% increase. The data indicates more rapid spending growth in certain years, especially in 2021 and 2020.

Payments tied to National Codes Established for State Medicaid Agencies services, while citywide, were primarily concentrated in only a few ZIP codes. In 2024, ZIP code 16627 accounted for $96,132, making up 100% of the city’s Medicaid payments in this category.

Additionally, only a small number of billing codes were responsible for most Medicaid payments within this category.

From 2023 to 2024, Coalport experienced an 82.8% rise in Medicaid spending for this service category, mirroring the 82.8% increase across all Medicaid claim types citywide for the same timeframe.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending totaled about $871.7 billion in fiscal 2023, which was 18% of national health expenditures, and marked a significant rise from roughly $613.5 billion in 2019, before the COVID-19 pandemic.

This growth of about 40% over several years was fueled by broader enrollment and greater usage during and following the pandemic.

Federal budget legislation passed during the Trump administration introduced key reforms aimed at reducing federal Medicaid outlays and reshaping the program. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is estimated to trim federal Medicaid spending by over $1 trillion in the next decade and brings changes such as work requirements and higher cost-sharing, which may cut coverage and funding for some enrollees. These policy shifts are expected to increase states’ financial responsibility and curb federal Medicaid growth, while the program continues to cover millions nationwide.

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.