In 2024, York Medicaid providers billed $22,251,294 for services categorized under the National Codes Established for State Medicaid Agencies, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflected a 4.1% rise from 2023, when the total was $21,375,790 for the same services.
Medicaid is a state-administered health insurance program funded in partnership by federal and state governments. The program supports low-income residents, seniors, children, and individuals with disabilities, and is a major component of the U.S. health care system.
Medicaid spending shifts show how taxpayer-funded health care resources are distributed within local areas.
The category “National Codes Established for State Medicaid Agencies” encompasses Medicaid-billed services grouped by care type, using standardized HCPCS and CPT coding. For this report, each code was consistently assigned to one service category by code prefix and numbering scheme, which helped ensure accuracy and avoid duplication in ranking services over time.
Although Medicaid expenditures rose in several service groups, payments in the National Codes Established for State Medicaid Agencies category accounted for the highest Medicaid total in York in 2024.
Across Pennsylvania, National Codes Established for State Medicaid Agencies ranked as the state’s second-largest Medicaid payment category in 2024.
During the five years up to 2024, National Codes Established for State Medicaid Agencies payments in York were up $15,355,399, or 222.7%. Multiple periods, including 2020 and 2021, saw large annual spending increases as growth accelerated.
While such payments impacted all sections of York, a few ZIP codes received most of the payment volume. In 2024, the leading ZIP codes were 17402, totaling $15,130,980, 17401, with $5,594,006, and 17403, at $1,526,306. These 3 accounted for the entire city’s Medicaid payments in this service grouping during the year.
Payments within the National Codes Established for State Medicaid Agencies category were concentrated in only a few specific billing codes.
Looking at annual changes, Medicaid payments specifically for National Codes Established for State Medicaid Agencies in York increased 4.1% from 2023 to 2024, compared with a 2.4% rise seen across all Medicaid billing categories here in the same time frame.
Figures from the Centers for Medicare & Medicaid Services show joint federal and state Medicaid outlays reached about $871.7 billion nationwide in fiscal year 2023, which was around 18% of total national health care expenditures, a significant increase from $613.5 billion in 2019, ahead of the COVID-19 outbreak.
This expansion—roughly 40% over a few years—primarily reflects increased enrollment and utilization driven by the pandemic and its aftermath.
Recent federal budget legislation enacted under the Trump administration introduced major changes to Medicaid funding. For instance, the “One Big Beautiful Bill Act,” passed in 2025, is expected to reduce federal spending on Medicaid by over $1 trillion over 10 years. The law brings work requirements and higher cost-sharing rules, potentially decreasing federal coverage and shifting more costs to states, possibly limiting federal Medicaid outlays despite the program still covering millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $6,895,895 | 170.3% |
| 2021 | $15,755,324 | 128.5% |
| 2022 | $14,062,782 | -10.7% |
| 2023 | $21,375,789 | 52% |
| 2024 | $22,251,293 | 4.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $22,251,293 | 34.1% |
| 2 | Evaluation and Management | $15,297,054 | 23.5% |
| 3 | Medicine Services and Procedures | $7,579,448 | 11.6% |
| 4 | Alcohol and Drug Abuse Treatment | $6,359,031 | 9.8% |
| 5 | Temporary National Codes (Non-Medicare) | $3,602,758 | 5.5% |
| 6 | Procedures / Professional Services | $3,587,870 | 5.5% |
| 7 | Radiology Procedures | $1,731,732 | 2.7% |
| 8 | Ambulance and Other Transport Services and Supplies | $1,533,967 | 2.4% |
| 9 | Pathology and Laboratory Procedures | $939,404 | 1.4% |
| 10 | Dental Services | $610,241 | 0.9% |
| 11 | Vision Services | $525,660 | 0.8% |
| 12 | Surgery | $369,913 | 0.6% |
| 13 | Durable Medical Equipment | $340,219 | 0.5% |
| 14 | Medical And Surgical Supplies | $241,436 | 0.4% |
| 15 | Enteral and Parenteral Therapy | $144,370 | 0.2% |
| 16 | Anesthesia | $36,271 | 0.1% |
| 17 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $9,023 | <0.1% |
| 18 | Hearing Services | $1,220 | <0.1% |
| 19 | Temporary Codes | $1,029 | <0.1% |
| 20 | Drugs Administered Other than Oral Method | $30 | <0.1% |
| 21 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 21 | Chemotherapy Drugs | $0 | <0.1% |
| 21 | Outpatient PPS | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1003 | Lpn/lvn services up to 15min | $13,382,882 | 35 |
| T1015 | Clinic service | $6,991,344 | 526 |
| T1017 | Targeted case management | $980,740 | 19 |
| T1016 | Case management | $683,928 | 10 |
| T2023 | Targeted case mgmt per month | $107,100 | 10 |
| T1002 | Rn services up to 15 minutes | $84,368 | 26 |
| T1001 | Nursing assessment/evaluatn | $20,930 | 9 |
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.
