Charleroi Medicaid payments for National Codes Established for State Medicaid Agencies total $1,792,838 for 2024

In 2024, Medicaid providers in Charleroi submitted $1,792,838 in claims for services within the National Codes Established for State Medicaid Agencies category, the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represents a 0.5% rise from 2023, when billings for the same service type reached $1,783,141.

Medicaid serves as a public health insurance option administered by the states and jointly financed by federal and state governments. It provides coverage for low-income individuals, families, children, seniors, and people with disabilities, making it a cornerstone of the U.S. health care system.

Since Medicaid payments are sourced from taxpayers, shifts in local billing demonstrate how health care funds are distributed in a community.

The “National Codes Established for State Medicaid Agencies” category groups Medicaid-billed services identified through specific HCPCS and CPT code groupings corresponding to the type of care. For this report, each billing code was assigned to one service category using systematic code prefixes and number ranges, enabling related services to be tracked together without overlap and preserving accurate rankings over time.

National Codes Established for State Medicaid Agencies was the leading category for total Medicaid payments in Charleroi in 2024, although multiple service categories saw spending gains.

Statewide, National Codes Established for State Medicaid Agencies was the second-largest Medicaid payment category in Pennsylvania for 2024.

Medicaid payments tied to the National Codes Established for State Medicaid Agencies category in Charleroi increased $1,201,098, or 203%, over the five years preceding 2024. Growth accelerated in some years, notably in 2021 and 2020, with substantial year-over-year increases reported.

While service spending was citywide, payments related to National Codes Established for State Medicaid Agencies were concentrated in a small number of ZIP codes. In 2024, ZIP code 15022 accounted for $1,792,838—the entirety of Charleroi’s Medicaid payments in this category. As a result, this one ZIP code made up 100% of payments tied to the category locally.

Within the National Codes Established for State Medicaid Agencies category, a small set of billing codes drew the largest Medicaid payments.

Comparatively, Medicaid payments connected to the National Codes Established for State Medicaid Agencies category in Charleroi rose 0.5% between 2024 and 2023, while payments across all claim categories citywide changed by 3.5% over the same span.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures reached approximately $871.7 billion for fiscal year 2023, making up about 18% of the nation’s total health spending. This is up sharply from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This represents about 40% growth in a few years, driven largely by expanded enrollment and greater utilization during and following the pandemic.

Recent federal budget laws during the Trump administration included major proposals to reduce Medicaid funding and adjust the program’s structure. The “One Big Beautiful Bill Act,” signed in 2025, is expected to lower federal Medicaid spending by more than $1 trillion over a decade and add measures like work requirements and higher cost-sharing that could restrict coverage and funds for some enrollees. These changes are anticipated to increase costs for states and constrain federal Medicaid spending growth, even as the program continues covering 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.