Pinehill Medicaid payments in National Codes category climb 308% in 2024

Pinehill’s Medicaid providers submitted $21,968 in claims for services under the National Codes Established for State Medicaid Agencies category in 2024, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 308% rise over 2023, when the claims for this service type totaled $5,388.

Medicaid operates as a public health insurance initiative managed by states and financed through joint federal and state funding. The program aids low-income people and families, the elderly, children, and those with disabilities, making it a significant component of U.S. health care.

Because taxpayer dollars fund Medicaid payments, shifts in local billing levels illustrate how community health resources are deployed.

The National Codes Established for State Medicaid Agencies category encompasses a range of Medicaid-covered services defined according to care type, using standardized HCPCS and CPT codes. For this report, each billing code was linked to one service category based on uniform code prefixes and numerical spans to allow precise tracking and avoid duplicate counts or inconsistent rankings through different time periods.

While Medicaid expenditures grew in multiple service categories, National Codes Established for State Medicaid Agencies had the highest total Medicaid payments in Pinehill for 2024.

Statewide, National Codes Established for State Medicaid Agencies was the second-largest Medicaid payment category by total value in New Mexico for 2024.

Throughout the five years leading up to 2024, Medicaid payments for the National Codes Established for State Medicaid Agencies in Pinehill rose by $21,968, or 0%. Certain timeframes saw marked increases year-over-year, especially in 2023 and 2022.

Payments for care under the National Codes Established for State Medicaid Agencies spanned locations citywide, but most funds in 2024 were concentrated among just a few ZIP codes. The top ZIP code, 87357, received $21,967. Combined, the top 1 ZIP codes made up all of Pinehill’s 2024 Medicaid payments in this service category.

Within the National Codes Established for State Medicaid Agencies, the majority of the payments were focused on a select group of individual billing codes.

For context, the 308% jump in Pinehill’s Medicaid payments under the National Codes Established for State Medicaid Agencies category between 2024 and 2023 matched the same percentage change seen across all Medicaid claim categories in the city during that period.

According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid outlays totaled approximately $871.7 billion in fiscal 2023, accounting for around 18% of total U.S. health spending, a substantial increase from roughly $613.5 billion in 2019 before the COVID-19 pandemic.

This equates to nearly 40% growth over several years, largely driven by expanded enrollment and increased use of services tied to the pandemic period and its aftermath.

Recent federal budgeting under the Trump administration brought forward major plans to reduce Medicaid funding and reorganize the program. The “One Big Beautiful Bill Act,” enacted in 2025, aims to decrease federal Medicaid spending by more than $1 trillion over the next decade and adds policy changes including work requirements and higher cost-sharing. These changes are anticipated to restrict federal support growth, increase state obligations, and potentially limit coverage for some members, as the program serves tens of millions nationwide.

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.