Johnson City sees $18,120,200 in Medicaid spending for national code services in 2024

Providers in Johnson City billed Medicaid a total of $18,120,200 for services within the National Codes Established for State Medicaid Agencies classification in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects a 207.5% jump from 2023, during which providers filed $5,893,176 in claims for this category.

Medicaid, which operates through joint state and federal support, is a public health insurance program covering low-income residents, seniors, children, and people with disabilities. It represents one of the central means for U.S. health care delivery. More information is available from the Commonwealth Fund.

As a public program funded by taxpayers, local fluctuations in Medicaid spending reflect how health care resources flow within communities.

The “National Codes Established for State Medicaid Agencies” category groups services billed under specific standardized HCPCS and CPT code ranges, as defined by the type of care delivered. For consistency, each code for this data set was classified into one category using established prefixes and ranges, enabling reliable grouping and comparison while preventing both overlap and misranking.

Though Medicaid spending increased in several categories, National Codes Established for State Medicaid Agencies represented the second-highest Medicaid spending category in Johnson City for 2024.

Statewide in Tennessee, the National Codes Established for State Medicaid Agencies category stood first in total Medicaid outlays during 2024.

Over the five years preceding 2024, Johnson City saw Medicaid outlays for this category increase by $14,828,934, a growth of 450.6%. Certain periods, especially 2022 and 2023, recorded substantially higher year-over-year gains.

This expenditure, although spread across the city, was largely concentrated within a few ZIP codes. In 2024, the ZIP codes accounting for the highest Medicaid payments in this category were 37601 with $7,897,880, 37604 with $6,452,632, and 37615 with $3,769,686. Together, these 3 ZIP codes made up 100% of total Medicaid payments for the category in Johnson City in 2024.

Most Medicaid payments within this service category were focused on a handful of individual billing codes.

To compare, the 207.5% rise in these Medicaid payments between 2023 and 2024 far outpaced the 10.6% change noted across all Medicaid claim categories in Johnson City over the same span.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid costs reached approximately $871.7 billion in the 2023 fiscal year. This figure represents about 18% of national health spending and is sharply higher than the approximate $613.5 billion recorded in 2019, prior to the COVID-19 pandemic.

An estimated 40% jump in Medicaid spending over a few years has mainly resulted from increased enrollment and greater utilization spurred by the pandemic and its aftermath.

Recent federal budget measures under the Trump administration have included extensive proposals to reduce national Medicaid spending and alter the program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid spending by over $1 trillion over 10 years. The law also imposes new work requirements and higher cost sharing, potentially lowering coverage and funding for some recipients, shifting additional costs to states, and capping the expansion of federal Medicaid support, though the program will still cover 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.