Providers serving Medicaid patients in Burlington billed $7,855,956 for services under the National Codes Established for State Medicaid Agencies category in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This amount represented a 66.8% jump from 2023, when total claims under this category reached $4,708,581.
Medicaid, which is administered by the states and financed by both federal and state governments, provides health coverage for low-income individuals, families, seniors, children and people with disabilities. This makes it one of the largest components of the nation’s health care landscape.
Because taxpayer dollars fund Medicaid payments, shifts in local billing figures reflect changes in the distribution of public health care resources throughout a community.
The “National Codes Established for State Medicaid Agencies” classification includes Medicaid services identified by the care provided, defined through standard HCPCS and CPT code ranges. The analysis used uniform code prefixes and numeric intervals to consistently group billings into exclusive service categories, ensuring each claim was counted once and allowing for accurate trends over time.
Increased Medicaid expenditures occurred in multiple service areas, but in Burlington the National Codes Established for State Medicaid Agencies category held sixth place by dollar volume among Medicaid service categories in 2024.
Statewide, the National Codes Established for State Medicaid Agencies category ranked first in North Carolina for Medicaid payments in 2024.
Between 2019 and 2024, Medicaid payments attached to the National Codes Established for State Medicaid Agencies category in Burlington rose by $4,482,019, or 132.8%. Periods of especially fast growth included both 2023 and 2020, based on notable year-to-year increases in spending.
Spending on the National Codes Established for State Medicaid Agencies group in Burlington appeared citywide but was primarily confined to a small number of ZIP codes. In 2024, ZIP codes 27215 accounted for $5,074,384, 27217 for $2,644,248 and 27216 for $137,322 in spending, so the top three ZIP codes made up 100% of the Medicaid payments linked to this category in Burlington that year.
Medicaid claims for services in the National Codes Established for State Medicaid Agencies were also concentrated among a relatively small set of unique billing codes.
When comparing categories, National Codes Established for State Medicaid Agencies saw a 66.8% gain in Burlington from 2023 to 2024, versus a 4.3% increase for all Medicaid billing types in the city during this interval.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending together reached about $871.7 billion in fiscal 2023, making up roughly 18% of U.S. health expenditures, a significant rise from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This change amounts to around 40% growth in just several years, influenced substantially by expanded enrollment and increased use throughout and following the pandemic period.
Federal budget measures under the Trump administration have included sweeping proposals to trim Medicaid funding and adjust how the program operates. The “One Big Beautiful Bill Act,” which became law in 2025, is set to reduce federal Medicaid spending by more than $1 trillion over a decade and implements requirements such as work policies and greater cost-sharing. These shifts are likely to transfer more spending responsibilities to states and restrain the expansion of federal Medicaid funding, although the program continues serving many millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $3,373,936 | 17% |
| 2021 | $2,557,602 | -24.2% |
| 2022 | $1,910,680 | -25.3% |
| 2023 | $4,708,580 | 146.4% |
| 2024 | $7,855,955 | 66.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Pathology and Laboratory Procedures | $191,446,045 | 72.1% |
| 2 | Procedures / Professional Services | $19,770,690 | 7.4% |
| 3 | Evaluation and Management | $15,216,756 | 5.7% |
| 4 | Medicine Services and Procedures | $13,339,005 | 5% |
| 5 | Alcohol and Drug Abuse Treatment | $12,217,310 | 4.6% |
| 6 | National Codes Established for State Medicaid Agencies | $7,855,955 | 3% |
| 7 | Temporary National Codes (Non-Medicare) | $2,578,525 | 1% |
| 8 | Dental Services | $1,457,260 | 0.5% |
| 9 | Surgery | $1,185,238 | 0.4% |
| 10 | Radiology Procedures | $239,459 | 0.1% |
| 11 | Durable Medical Equipment | $81,760 | <0.1% |
| 12 | Anesthesia | $45,054 | <0.1% |
| 13 | Medical And Surgical Supplies | $35,826 | <0.1% |
| 14 | Drugs Administered Other than Oral Method | $20,444 | <0.1% |
| 15 | Orthotic Procedures and services | $14,089 | <0.1% |
| 16 | Coronavirus Diagnostic Panel | $10,456 | <0.1% |
| 17 | Temporary Codes | $5,775 | <0.1% |
| 18 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $5,450 | <0.1% |
| 19 | Administrative, Miscellaneous and Investigational | $4,798 | <0.1% |
| 20 | Vision Services | $561 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $2,534,772 | 14 |
| T1017 | Targeted case management | $2,519,631 | 22 |
| T1015 | Clinic service | $1,153,200 | 218 |
| T2025 | Waiver service, nos | $772,134 | 23 |
| T2021 | Day habil waiver per 15 min | $594,513 | 11 |
| T1016 | Case management | $182,939 | 18 |
| T2041 | Support broker waiver/15 min | $93,685 | 14 |
| T1002 | Rn services up to 15 minutes | $5,079 | 6 |
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.
