In 2024, Monroe Medicaid providers billed $717,149 for services categorized under National Codes Established for State Medicaid Agencies, according to data compiled by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represented a 23.1% increase over 2023, when providers billed $582,508 for the same service category.
Medicaid, operated by states with federal and state funding, covers low-income adults, seniors, children and people with disabilities, making it a leading component of the U.S. health care system. For additional explanation about how Medicaid is funded, see here.
Because taxpayer funds support Medicaid, shifts in billing volumes reveal how health spending is directed within local communities.
The National Codes Established for State Medicaid Agencies group encompasses Medicaid-billed services sorted by type, defined using standardized HCPCS and CPT numerical prefixes and groups. Each code analyzed was placed into a single service group, making it possible to review related services together and avoid double counting of payments or ranks in the analysis.
Multiple categories experienced growth in Medicaid expenditures, but National Codes Established for State Medicaid Agencies ranked third among all Medicaid payment categories in Monroe for 2024.
Statewide in Washington, the National Codes Established for State Medicaid Agencies category held the top spot in total Medicaid payments in 2024.
From five years before 2024 through the year itself, the category in Monroe recorded a total increase of $101,174—or 16.4%—with stronger growth periods, including sizeable increases in both 2021 and 2022.
Although Monroe saw this spending distributed citywide, most payments were concentrated in select ZIP codes; ZIP code 98272 accounted for $717,149 in 2024, making up 100% of all city Medicaid payments tied to National Codes Established for State Medicaid Agencies that year.
Within the category, Medicaid claims were also concentrated among a limited set of billing codes.
While payments for National Codes Established for State Medicaid Agencies grew by 23.1% from 2023 to 2024 in Monroe, all local Medicaid categories combined saw a 4.6% change during the same interval.
According to the Centers for Medicare & Medicaid Services, overall Medicaid spending by federal and state agencies amounted to roughly $871.7 billion in fiscal 2023, comprising approximately 18% of U.S. national health expenditures, with a sharp increase from about $613.5 billion in 2019 before the COVID-19 pandemic.
This represents about a 40% jump within several years, largely related to rising enrollment and utilization during and following the pandemic.
Federal budget measures enacted under the Trump administration have included proposals to significantly reduce federal Medicaid contributions and overhaul elements of the program. One example, the “One Big Beautiful Bill Act,” passed in 2025, is projected to slash federal Medicaid spending by more than $1 trillion over 10 years and imposes work requirements and new cost-sharing, potentially reducing benefit coverage and funding for certain enrollees. As a result, states may have to shoulder more Medicaid costs even as millions continue to depend on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $615,974 | -69% |
| 2021 | $1,064,825 | 72.9% |
| 2022 | $675,762 | -36.5% |
| 2023 | $582,507 | -13.8% |
| 2024 | $717,149 | 23.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $2,214,336 | 40.5% |
| 2 | Alcohol and Drug Abuse Treatment | $908,786 | 16.6% |
| 3 | National Codes Established for State Medicaid Agencies | $717,149 | 13.1% |
| 4 | Medicine Services and Procedures | $594,240 | 10.9% |
| 5 | Dental Services | $352,360 | 6.4% |
| 6 | Radiology Procedures | $338,021 | 6.2% |
| 7 | Ambulance and Other Transport Services and Supplies | $166,533 | 3% |
| 8 | Pathology and Laboratory Procedures | $137,756 | 2.5% |
| 9 | Procedures / Professional Services | $23,802 | 0.4% |
| 10 | Drugs Administered Other than Oral Method | $8,669 | 0.2% |
| 11 | Surgery | $4,230 | 0.1% |
| 12 | Medical And Surgical Supplies | $2,730 | <0.1% |
| 13 | Temporary Codes | $1,585 | <0.1% |
| 14 | Coronavirus Diagnostic Panel | $865 | <0.1% |
| 15 | Temporary National Codes (Non-Medicare) | $14 | <0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $1 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $663,258 | 85 |
| T2035 | Utility services waiver | $37,145 | 9 |
| T1017 | Targeted case management | $13,520 | 12 |
| T4526 | Adult size pull-on med | $1,153 | 1 |
| T4537 | Reusable underpad bed size | $958 | 1 |
| T4541 | Large disposable underpad | $813 | 1 |
| T1002 | Rn services up to 15 minutes | $300 | 1 |
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.
