Medicaid payments for national code services in New Berlin surge 111.9% in 2024

In 2024, Medicaid providers in New Berlin billed $1,788,915 for services falling under the National Codes Established for State Medicaid Agencies, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 111.9% increase over 2023, when $844,061 was submitted for similar services.

Medicaid is a public insurance program operated by states with joint federal and state funding. It provides coverage to low-income individuals and families, seniors, children, and people with disabilities, ranking as one of the largest components of the U.S. health care system. More information about Medicaid funding is available here.

Shifts in local Medicaid payment levels demonstrate how taxpayer-financed health care dollars are distributed within a community.

The “National Codes Established for State Medicaid Agencies” group encompasses a series of Medicaid-billed services identified by type of care, utilizing standard HCPCS and CPT code categories. Analysis assigned each billing code to a distinct service class using matching code prefixes and number ranges, which allows for trend analysis over time while preventing overlap and maintaining the integrity of service rankings.

Growth in Medicaid spending was noted across multiple service areas, with the National Codes Established for State Medicaid Agencies category ranking third in total dollar value among New Berlin service categories in 2024.

Statewide, this service category held the top position in Wisconsin by aggregate Medicaid payments in 2024.

From five years before 2024, Medicaid spending in New Berlin for services under the National Codes Established for State Medicaid Agencies rose by $1,713,153, equal to a 2261.2% climb. Periods of accelerated growth included significant year-over-year increases in 2021 and 2022.

Although service payments were distributed throughout New Berlin, a handful of ZIP codes received the majority of funds. In 2024, ZIP code 53151 accounted for $1,788,915, representing 100% of Medicaid payments to this service category in New Berlin that year.

Within the category, specific billing codes accounted for the greatest share of Medicaid reimbursements.

For context, Medicaid spending for this category in New Berlin increased 111.9% from 2023 to 2024, compared to a 16.5% rise across all Medicaid claim types in the city over the same period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023. This represented about 18% of all national health expenditures, and a sharp increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This trend marks about 40% cumulative growth in a few years, largely driven by rising enrollment and increased service utilization during and following the pandemic.

Recent federal budget legislation under the Trump administration has proposed major reductions in federal Medicaid contributions and modifications to the structure of the program. The “One Big Beautiful Bill Act,” signed in 2025, is expected to reduce federal Medicaid funds by more than $1 trillion over 10 years, introducing work requirements and cost-sharing measures that may limit access or funding for certain populations. These policy changes are set to transfer more expenses to states and constrain federal growth, though Medicaid 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.