In 2024, Fairmont Medicaid providers billed a total of $384,504 for care identified under the National Codes Established for State Medicaid Agencies category, as shown in data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure reflects a 19.6% climb from 2023, when claims for the same service type reached $321,614.
Medicaid is a publicly funded health insurance program managed by states in partnership with federal and state governments. The program serves low-income residents, older adults, children, and disabled individuals, making it a foundational component of the U.S. health care landscape.
Since taxpayer funding supports Medicaid, shifting billing patterns locally reflect how community public health funding is directed.
The “National Codes Established for State Medicaid Agencies” category groups Medicaid-billed services aligned by care type, based on standardized HCPCS and CPT code designations. Each billing code for this report was exclusively grouped within a single service category according to specific prefixes and numeric ranges to allow consistent category comparisons and avoid multiple counts.
Among service types with increased Medicaid spending, National Codes Established for State Medicaid Agencies ranked third in Fairmont by overall Medicaid payments for 2024.
On the statewide level in North Carolina in 2024, National Codes Established for State Medicaid Agencies held the top position for total Medicaid reimbursements.
Between 2019 and 2024, Medicaid payments in Fairmont related to the National Codes Established for State Medicaid Agencies showed a jump of $350,667, marking a 47.7% rise. Notably large increases were observed in both 2020 and 2021, driving accelerated spending growth through the period.
Although recipients of care under this category were spread throughout Fairmont, most payments in 2024 were concentrated in just a few ZIP codes. ZIP code 28340, for instance, accounted for $384,503, representing all Medicaid beneficiaries in the city’s National Codes Established for State Medicaid Agencies grouping that year.
Spending within National Codes Established for State Medicaid Agencies was also centralized to a limited array of billing codes.
When comparing the period from 2023 to 2024, Fairmont saw a 19.6% rise in spending in the National Codes Established for State Medicaid Agencies category, while Medicaid payments across all claim types increased by 22.1% citywide during the same window.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023. This represented around 18% of national health spending, a significant jump from $613.5 billion in 2019 prior to the onset of COVID-19.
This uptick represents a roughly 40% increase over several years, largely attributed to increased enrollment figures and expanded use of health services during and following the pandemic.
Major budget measures adopted during the Trump administration included proposals to curtail federal Medicaid funds and modify the structure of the program. The “One Big Beautiful Bill Act,” enacted in 2025, is set to cut more than $1 trillion from federal Medicaid spending over ten years, introducing changes—such as work requirements and greater cost-sharing—that could potentially decrease benefit coverage and financial support for several recipients. These developments are expected to put additional funding responsibilities on states and restrain growth in federal Medicaid contributions, though coverage remains vital for tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $735,170 | 57.6% |
| 2021 | $798,191 | 8.6% |
| 2022 | $522,205 | -34.6% |
| 2023 | $321,613 | -38.4% |
| 2024 | $384,503 | 19.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $1,206,664 | 48.6% |
| 2 | Alcohol and Drug Abuse Treatment | $604,300 | 24.3% |
| 3 | National Codes Established for State Medicaid Agencies | $384,503 | 15.5% |
| 4 | Evaluation and Management | $165,495 | 6.7% |
| 5 | Temporary National Codes (Non-Medicare) | $54,182 | 2.2% |
| 6 | Dental Services | $34,340 | 1.4% |
| 7 | Pathology and Laboratory Procedures | $18,804 | 0.8% |
| 8 | Coronavirus Diagnostic Panel | $12,068 | 0.5% |
| 9 | Ambulance and Other Transport Services and Supplies | $3,415 | 0.1% |
| 10 | Procedures / Professional Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $324,983 | 25 |
| T1017 | Targeted case management | $59,520 | 11 |
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.
