Service providers in Cranston billed $31,016,524 to Medicaid for the National Codes Established for State Medicaid Agencies category during 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This reflects a 2.2% rise compared with the prior year, when claims for these services totaled $30,340,012.
Medicaid is a state-administered public health insurance program funded in partnership by federal and state governments. The program serves low-income individuals and families, seniors, children, and people with disabilities, making it one of the largest U.S. health care programs.
Since taxpayer contributions fund Medicaid, shifts in community billing levels reflect changes in local distribution of public health care spending.
The “National Codes Established for State Medicaid Agencies” category comprises a group of Medicaid-billed services categorized by care type, using established HCPCS and CPT code groupings. Each billing code was grouped into a single service category with consistent code ranges and prefixes, ensuring related services are analyzed as one group, avoiding double counting and supporting reliable ranking year to year.
While Medicaid expenditures increased across several service groups, National Codes Established for State Medicaid Agencies represented the largest total Medicaid payment in Cranston for 2024.
Across Rhode Island, this category also ranked as the top Medicaid expenditure statewide in 2024.
From 2019 to 2024, Cranston’s Medicaid payments under the National Codes Established for State Medicaid Agencies category increased by $11,492,231, or 58.9%. Certain years, notably 2022 and 2023, saw sharper annual growth.
Payments for this care category were made throughout Cranston but were mostly concentrated in a few ZIP codes. In 2024, the highest Medicaid payments for this category were in ZIP code 02910 with $12,011,794, followed by 02921 at $9,846,577, and 02920 at $9,117,420. Combined, these 3 ZIP codes made up 99.9% of Medicaid outlays for this care category in Cranston that year.
Within this category, Medicaid payments were heavily focused on a small subset of individual billing codes.
In comparison, Medicaid payments tied to this care category in Cranston grew 2.2% from 2023 to 2024, while the increase across all Medicaid claim categories in the city during that period was 1.8%.
Data from the Centers for Medicare & Medicaid Services show combined federal and state Medicaid spending reached roughly $871.7 billion in fiscal year 2023, accounting for around 18% of total U.S. health spending, a notable increase from about $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This growth—about 40% over several years—was largely due to higher enrollment and increased health care utilization during and after the pandemic.
Federal budget changes in the Trump administration included major proposals reducing Medicaid funding and restructuring the program. Signed into law in 2025, the “One Big Beautiful Bill Act,” is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years. The law introduces work requirements and increased cost-sharing, which may reduce benefits and funding for some recipients, shifting financial responsibility to the states even while Medicaid continues to serve millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $19,524,292 | -11.2% |
| 2021 | $22,069,871 | 13% |
| 2022 | $26,177,577 | 18.6% |
| 2023 | $30,340,012 | 15.9% |
| 2024 | $31,016,523 | 2.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $31,016,523 | 39.6% |
| 2 | Temporary National Codes (Non-Medicare) | $19,502,710 | 24.9% |
| 3 | Alcohol and Drug Abuse Treatment | $16,666,621 | 21.3% |
| 4 | Medicine Services and Procedures | $5,309,338 | 6.8% |
| 5 | Evaluation and Management | $1,844,887 | 2.4% |
| 6 | Temporary Codes | $1,131,745 | 1.4% |
| 7 | Enteral and Parenteral Therapy | $981,118 | 1.3% |
| 8 | Ambulance and Other Transport Services and Supplies | $444,611 | 0.6% |
| 9 | Dental Services | $393,792 | 0.5% |
| 10 | Pathology and Laboratory Procedures | $316,889 | 0.4% |
| 11 | Durable Medical Equipment | $299,966 | 0.4% |
| 12 | Surgery | $163,160 | 0.2% |
| 13 | Medical And Surgical Supplies | $88,848 | 0.1% |
| 14 | Radiology Procedures | $69,336 | 0.1% |
| 15 | Drugs Administered Other than Oral Method | $40,547 | 0.1% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $12,200 | <0.1% |
| 17 | Vision Services | $10,574 | <0.1% |
| 18 | Procedures / Professional Services | $7,056 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2033 | Res, nos waiver per diem | $17,236,349 | 43 |
| T2017 | Habil res waiver 15 min | $3,346,106 | 40 |
| T1024 | Team evaluation & management | $3,097,379 | 13 |
| T1015 | Clinic service | $2,243,043 | 139 |
| T2003 | N-et; encounter/trip | $1,165,418 | 42 |
| T1027 | Family training & counseling | $1,105,929 | 37 |
| T1016 | Case management | $601,620 | 19 |
| T2021 | Day habil waiver per 15 min | $466,837 | 15 |
| T1019 | Personal care ser per 15 min | $364,004 | 11 |
| T1030 | Rn home care per diem | $277,884 | 23 |
| T2019 | Habil sup empl waiver 15min | $265,409 | 14 |
| T1001 | Nursing assessment/evaluatn | $262,537 | 44 |
| T2022 | Case management, per month | $240,225 | 9 |
| T1002 | Rn services up to 15 minutes | $221,791 | 23 |
| T1005 | Respite care service 15 min | $68,018 | 6 |
| T2023 | Targeted case mgmt per month | $53,967 | 11 |
| T2020 | Day habil waiver per diem | $0 | 1 |
Note: HCPCS codes are included to show context for this category. Category rankings and totals are based on standardized service groupings, not single billing codes.
The information in this article is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. You can view the raw data here.
