In 2024, Burgettstown Medicaid providers billed $362,909 for services classified within the National Codes Established for State Medicaid Agencies category, using figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. That amount reflects a 97.9% jump from 2023, when $183,379 in similar service claims were filed.
Medicaid is a public health insurance program operated by states and funded with assistance from both federal and state governments. The program provides coverage to individuals and families with low incomes, seniors, children, and people with disabilities, comprising a large portion of the U.S. health care system.
As Medicaid payments depend on taxpayer funding, shifts in area billing patterns reveal how community health care dollars are being directed.
The “National Codes Established for State Medicaid Agencies” designation applies to a specific set of services, identified by the care provided and sorted through standardized HCPCS and CPT code classes. For analytic purposes, each code was grouped into a solitary service category using uniform code prefixes and number ranges, ensuring related service types could be reviewed collectively without duplicate reporting while allowing for clear year-over-year rankings.
Medicaid expenditures rose across several care categories, with National Codes Established for State Medicaid Agencies ranking as the second highest in Burgettstown by overall Medicaid payments in 2024.
On the state level, National Codes Established for State Medicaid Agencies held the No. 2 spot in Pennsylvania for total Medicaid payments in 2024.
Between 2019 and 2024, Medicaid funds allocated for services under National Codes Established for State Medicaid Agencies in Burgettstown grew by $158,455, a 77.5% gain. The pace of growth increased significantly during select periods, especially in 2021 and 2023, when substantial spikes were observed.
Spending in this category was dispersed throughout Burgettstown; however, most payments were focused in a small group of ZIP codes. In 2024, ZIP code 15021 accounted for $362,908, meaning this ZIP code represented 100% of all Medicaid spending in the National Codes Established for State Medicaid Agencies category for the city that year.
Medicaid payments for this category were further concentrated within a select group of individual billing codes.
Comparing 2023 and 2024, Medicaid payments in Burgettstown linked to the National Codes Established for State Medicaid Agencies climbed 97.9%, in contrast to a 5.9% shift across all Medicaid claim groups in the locality through the same interval.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending in fiscal year 2023 totaled about $871.7 billion, representing roughly 18% of total national health expenditures, up sharply from approximately $613.5 billion in 2019 before the COVID-19 pandemic.
This surge amounts to nearly 40% growth over a few years, attributed largely to greater enrollment and rising demand throughout and following the pandemic period.
Recently enacted federal budget laws under the Trump administration featured substantive proposals to reduce federal Medicaid funding and reshape the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid outlays by over $1 trillion in the next ten years and implements new requirements such as work provisions and increased cost-sharing. These changes may cut or restrict coverage and funding for certain individuals, shift additional responsibilities to the states, and curb federal Medicaid support growth, although the program still covers tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $204,454 | – |
| 2021 | $312,061 | 52.6% |
| 2022 | $152,299 | -51.2% |
| 2023 | $183,378 | 20.4% |
| 2024 | $362,908 | 97.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $919,213 | 69.3% |
| 2 | National Codes Established for State Medicaid Agencies | $362,908 | 27.4% |
| 3 | Medicine Services and Procedures | $29,808 | 2.2% |
| 4 | Surgery | $9,692 | 0.7% |
| 5 | Pathology and Laboratory Procedures | $3,565 | 0.3% |
| 6 | Radiology Procedures | $1,147 | 0.1% |
| 7 | Drugs Administered Other than Oral Method | $393 | <0.1% |
| 8 | Dental Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $362,908 | 53 |
Note: HCPCS codes are listed within the category for context. Category totals and rankings in this article are determined using standardized service groupings, rather than by each billing code individually.
Information reported in this article is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the source data here.
