National Codes category tops Dousman Medicaid payments at $135,000 in 2024

In 2024, Dousman Medicaid providers billed $135,000 for services under the National Codes Established for State Medicaid Agencies category, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents a 10.1% rise over 2023, when providers filed $122,625 in claims for these services.

Medicaid is operated by states with joint federal and state funding, covering low-income individuals and families, children, seniors, and people with disabilities. The program is one of the nation’s largest health care components.

Shifts in local Medicaid billing illustrate how taxpayer-funded health care resources are used within communities.

The “National Codes Established for State Medicaid Agencies” category includes a range of Medicaid services categorized by care type, based on standardized HCPCS and CPT codes. Billing codes for this study were placed into one service category according to shared numeric ranges and code prefixes. This approach ensured accurate totals, eliminated double counting, and allowed for consistent rankings over time.

National Codes Established for State Medicaid Agencies was the leading Medicaid service category by total spending in Dousman in 2024, with similar results observed across multiple service groups as overall Medicaid disbursement increased.

Statewide, this category also ranked highest for Medicaid payments in Wisconsin for 2024.

From 2019 through 2024, Dousman saw Medicaid payments in the National Codes Established for State Medicaid Agencies category grow by $135,000, indicating a 0% change during the five-year period. Certain intervals, like 2023 and 2022, featured heightened year-to-year growth in spending.

Spending within Dousman for this category was highly concentrated among a few ZIP codes. In 2024, ZIP code 53118 accounted for the full $135,000 in Medicaid payments in this category, representing 100% of local reimbursements tied to National Codes Established for State Medicaid Agencies.

Specific billing codes drew most Medicaid spending within the National Codes Established for State Medicaid Agencies category in 2024.

Comparisons show that between 2023 and 2024, Dousman’s Medicaid payments for this category rose 10.1%, matching the overall change for all Medicaid service categories in the city during the same period.

The Centers for Medicare & Medicaid Services reports that total federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023. This was about 18% of total U.S. health care expenditures, a notable increase from about $613.5 billion in 2019, before COVID-19.

This approximately 40% growth over several years owes largely to larger enrollment and increased utilization surrounding the pandemic period.

Federal budget measures under the Trump administration included proposals aimed at reducing and restructuring Medicaid’s federal funding. Legislation such as the “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid expenditures by over $1 trillion in the coming decade. Changes under this legislation include the introduction of work requirements and greater cost-sharing, resulting in possible reductions in coverage and funding for certain groups and likely increasing cost responsibility for states.

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.