In 2024, Medicaid providers in Northampton submitted $25,769,412 in claims for services classified within the National Codes Established for State Medicaid Agencies, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total represents a 62.4% rise from 2023, when providers billed $15,870,538 for these services.
Medicaid serves as a public health insurance program managed by the states and financed by both federal and state governments. It provides coverage for low-income residents, children, seniors, and people with disabilities, which makes it a major component of the U.S. health care landscape.
Since taxpayer funds support Medicaid, shifts in local billing offer insight into how community health care dollars are distributed.
The National Codes Established for State Medicaid Agencies category represents services billed under standardized HCPCS and CPT codes. For this report, each code was allocated to a single service category using consistent prefixes and numeric ranges, enabling the aggregation of similar services and ensuring accurate, non-duplicative rankings over time.
Medicaid spending grew in several service categories, but National Codes Established for State Medicaid Agencies led in total payments in Northampton during 2024.
Statewide, in Massachusetts, National Codes Established for State Medicaid Agencies also placed first by overall Medicaid payouts in 2024.
From 2019 through 2024, Medicaid payments for National Codes Established for State Medicaid Agencies in Northampton increased by $5,708,351, or 18.1%. The pace of spending growth accelerated during certain intervals, especially in 2020 and 2021, with significant year-over-year gains.
While payments for services in this category were spread throughout Northampton, the majority were concentrated in a small number of ZIP codes. In 2024, ZIP code 01060 generated $25,769,412 in Medicaid payments for National Codes Established for State Medicaid Agencies services, with the top ZIP code accounting for 100% of category-related payments within the city for the year.
Within the National Codes Established for State Medicaid Agencies category, payments primarily centered around a few specific billing codes.
Comparatively, the 62.4% year-over-year rise in Northampton’s Medicaid payments in this category outpaced the 52% increase seen across all Medicaid claim types citywide in the same period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures totaled about $871.7 billion in fiscal year 2023, accounting for around 18% of all national health spending—substantially higher than the approximately $613.5 billion spent in 2019, prior to the COVID-19 pandemic.
This represents close to 40% growth over a few years, largely influenced by increased enrollment and higher usage throughout and following the pandemic era.
Recent federal budget measures during the Trump administration included proposals to trim federal Medicaid funding and change program rules. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is slated to cut over $1 trillion from federal Medicaid spending over the next 10 years and introduces work requirements and greater cost-sharing that may decrease coverage and funding for certain groups. These changes are expected to shift additional financial responsibility to states and restrict federal Medicaid growth, even as millions continue to rely on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $31,477,763 | 8.6% |
| 2021 | $31,681,868 | 0.6% |
| 2022 | $15,856,491 | -50% |
| 2023 | $15,870,537 | 0.1% |
| 2024 | $25,769,412 | 62.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $25,769,412 | 42% |
| 2 | Alcohol and Drug Abuse Treatment | $23,821,597 | 38.8% |
| 3 | Temporary National Codes (Non-Medicare) | $3,934,385 | 6.4% |
| 4 | Medicine Services and Procedures | $2,608,493 | 4.2% |
| 5 | Evaluation and Management | $2,535,088 | 4.1% |
| 6 | Pathology and Laboratory Procedures | $879,339 | 1.4% |
| 7 | Ambulance and Other Transport Services and Supplies | $804,432 | 1.3% |
| 8 | Radiology Procedures | $401,469 | 0.7% |
| 9 | Procedures / Professional Services | $313,152 | 0.5% |
| 10 | Dental Services | $186,458 | 0.3% |
| 11 | Surgery | $83,915 | 0.1% |
| 12 | Coronavirus Diagnostic Panel | $44,254 | 0.1% |
| 13 | Drugs Administered Other than Oral Method | $12,018 | <0.1% |
| 14 | Administrative, Miscellaneous and Investigational | $1,072 | <0.1% |
| 15 | Hearing Services | $935 | <0.1% |
| 16 | Temporary Codes | $193 | <0.1% |
| 17 | Other Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $22,744,819 | 10 |
| T2023 | Targeted case mgmt per month | $1,159,430 | 14 |
| T2046 | Hospice long term care, r&b | $753,444 | 9 |
| T2003 | N-et; encounter/trip | $604,671 | 10 |
| T1024 | Team evaluation & management | $328,709 | 11 |
| T2019 | Habil sup empl waiver 15min | $141,621 | 10 |
| T1015 | Clinic service | $33,639 | 10 |
| T1027 | Family training & counseling | $3,076 | 2 |
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.
