Paoli Medicaid providers billed $2.9 million for national codes established for state agencies in 2024

In 2024, Medicaid providers in Paoli billed $2,945,684 for services within the National Codes Established for State Medicaid Agencies category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflected a 2.8% rise from 2023, when providers recorded $2,865,204 in claims for these services.

Medicaid is a state-operated health insurance program whose funding comes jointly from federal and state governments. It offers coverage for low-income families and individuals, seniors, children, and people with disabilities, and is one of the nation’s largest health care programs. More details are available at this resource.

Because Medicaid payments are sourced from taxpayers, shifts in local billing provide a view into how public health care funds are distributed within a community.

The “National Codes Established for State Medicaid Agencies” category encompasses certain Medicaid services, classified by care type and identified through standard HCPCS and CPT code groupings. In this analysis, each code grouping was allocated to one service type using fixed prefixes and numeric intervals. This consistent methodology enables comparison of related services while preventing duplication and retaining the accuracy of rankings from year to year.

Among various service types that saw increases, the National Codes Established for State Medicaid Agencies category received the highest total Medicaid payments in Paoli for 2024.

Statewide, this category was the second highest for total Medicaid payments in Pennsylvania in 2024.

Examining data from the five years preceding 2024, Medicaid payments for this category increased by $1,986,673, or 207.2%. Noticeable spending increases occurred in certain periods, particularly in 2021 and 2023.

Although Medicaid payments for these services appeared throughout Paoli, they were mainly concentrated in a small number of ZIP codes. In 2024, ZIP code 19301 alone saw $2,945,684 in Medicaid payments for this category, representing 100% of the city’s total in this group for the year.

A limited number of individual billing codes were responsible for most Medicaid spending under the National Codes Established for State Medicaid Agencies category.

From 2023 to 2024, payments in this category increased by 2.8% in Paoli. This pace was slower compared with the 5.7% change across all local Medicaid claim categories during the period.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid expenditure reached about $871.7 billion in fiscal year 2023, comprising roughly 18% of all national health spending. This was up from around $613.5 billion in 2019, ahead of the COVID-19 pandemic.

This increase amounts to about 40% over several years, mostly driven by increased enrollment and service usage during and in the aftermath of the pandemic.

Recent federal budget legislation from the Trump administration proposed significant reductions to federal Medicaid spending as well as program restructures. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid outlays by more than $1 trillion over 10 years. New policies include work requirements and greater cost-sharing for beneficiaries, which could result in decreased coverage and funding for some groups. These shifts are expected to increase states’ funding share and slow federal Medicaid support even as the program continues covering tens of millions of people.

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.