In 2024, Medicaid providers in Johnston billed $3,165,234 for services in the National Codes Established for State Medicaid Agencies category, as reported by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total marks a 66.8% rise over 2023, when $1,897,935 was billed for the same category of services.
Medicaid, a public health insurance initiative operated by the states and financed through both federal and state contributions, serves low-income individuals and families, seniors, children and people with disabilities. It remains one of the largest aspects of the U.S. health system.
Since Medicaid funding is drawn from taxpayers, shifts in local billing highlight how public funds for health care are distributed across communities.
The “National Codes Established for State Medicaid Agencies” group encompasses a range of Medicaid services classified by the specific care provided, following standardized HCPCS and CPT code groupings. For this analysis, each billing code was matched to a service category using consistent prefixes and numeric sequences to group related services, offering a comprehensive view while ensuring accuracy and preventing duplication in rankings over time.
Across several service groupings, Medicaid spending grew, with National Codes Established for State Medicaid Agencies finishing as Johnston’s second highest by total payments in 2024.
Statewide, Rhode Island saw National Codes Established for State Medicaid Agencies at the top by total Medicaid payments in 2024.
From 2020 to 2024, Medicaid payments linked to National Codes Established for State Medicaid Agencies in Johnston rose by $2,077,291, a 190.9% increase. Growth in spending accelerated at points, with significant year-over-year gains noted in 2021 and 2022.
While Medicaid payments for care in this category were distributed citywide, the majority were concentrated within a small number of ZIP codes. In 2024, ZIP code 02919 accounted for $3,165,233. Altogether, the leading ZIP code represented 100% of Medicaid payments associated with this service category in Johnston during the year.
Within the National Codes Established for State Medicaid Agencies grouping, a few billing codes accounted for most Medicaid payments.
Between 2024 and 2023, the category’s Medicaid payments in Johnston grew by 66.8%, surpassing the citywide growth across all Medicaid claim categories, which was 8.8% for the same period.
According to the Centers for Medicare & Medicaid Services, joint federal and state spending for Medicaid reached about $871.7 billion in fiscal year 2023, making up roughly 18% of all national health spending, an increase from $613.5 billion in 2019 before the COVID-19 pandemic.
This growth reflects an increase of about 40% over a few years, largely driven by higher enrollment and greater use of services during and after the pandemic.
Recent federal budget legislation during the Trump administration introduced substantial proposals to cut federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal spending by more than $1 trillion over the next decade, introducing changes such as work requirements and increased cost-sharing that could limit access and funding for some enrollees. This shift is likely to increase cost burdens on states and limit federal Medicaid growth, even as the program continues serving tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,087,943 | -45.3% |
| 2021 | $1,376,745 | 26.5% |
| 2022 | $1,621,420 | 17.8% |
| 2023 | $1,897,934 | 17.1% |
| 2024 | $3,165,233 | 66.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $4,527,526 | 37.5% |
| 2 | National Codes Established for State Medicaid Agencies | $3,165,233 | 26.2% |
| 3 | Alcohol and Drug Abuse Treatment | $1,598,996 | 13.2% |
| 4 | Evaluation and Management | $990,014 | 8.2% |
| 5 | Medicine Services and Procedures | $676,405 | 5.6% |
| 6 | Medical And Surgical Supplies | $584,295 | 4.8% |
| 7 | Durable Medical Equipment | $177,712 | 1.5% |
| 8 | Ambulance and Other Transport Services and Supplies | $162,869 | 1.3% |
| 9 | Pathology and Laboratory Procedures | $151,081 | 1.3% |
| 10 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $20,028 | 0.2% |
| 11 | Vision Services | $18,364 | 0.2% |
| 12 | Surgery | $8,392 | 0.1% |
| 13 | Radiology Procedures | $2,269 | <0.1% |
| 14 | Dental Services | $526 | <0.1% |
| 15 | Procedures / Professional Services | $34 | <0.1% |
| 16 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1041 | Comm bh clinic svc per month | $1,132,114 | 2 |
| T1015 | Clinic service | $786,231 | 86 |
| T1005 | Respite care service 15 min | $591,930 | 11 |
| T1024 | Team evaluation & management | $215,144 | 10 |
| T2022 | Case management, per month | $153,886 | 15 |
| T1016 | Case management | $127,263 | 13 |
| T1001 | Nursing assessment/evaluatn | $65,787 | 11 |
| T1017 | Targeted case management | $55,335 | 6 |
| T2024 | Serv asmnt/care plan waiver | $26,758 | 6 |
| T2003 | N-et; encounter/trip | $10,782 | 5 |
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.
