Pascoag Medicaid payments for national codes climb to $510,031 in 2024

In 2024, Medicaid providers in Pascoag submitted $510,031 in claims for services grouped under the National Codes Established for State Medicaid Agencies, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 21.2% increase compared to 2023, when providers filed $420,677 in claims within this same service category.

Medicaid is a state-run public health insurance program funded jointly by federal and state governments. It serves low-income individuals, families, seniors, children, and people with disabilities, making it one of the largest segments of the U.S. health care system.

Since Medicaid funding comes from taxpayers, shifts in local billing patterns reveal how community health dollars are spent.

The “National Codes Established for State Medicaid Agencies” category includes Medicaid services identified by specific types of care, based on consistent HCPCS and CPT code groupings. For this report, each billing code was linked to a single service group by standardized code prefixes and number ranges, allowing for analysis of similar services without double counting and ensuring accurate year-over-year comparisons.

Spending increased in multiple Medicaid service categories, with National Codes Established for State Medicaid Agencies accounting for the highest total payment in Pascoag during 2024.

On a statewide basis, National Codes Established for State Medicaid Agencies also ranked first in Rhode Island for total Medicaid payments in 2024.

Over the five years ending in 2024, Medicaid payments for National Codes Established for State Medicaid Agencies in Pascoag rose by $251,223 or 97.1%. The pace of growth was faster in certain periods, especially with substantial annual increases reported in 2023 and 2022.

Although this care category’s spending was distributed citywide, payments were primarily concentrated in a few ZIP codes. For 2024, ZIP code 02859 accounted for $510,030, representing 100% of Medicaid payments linked to National Codes Established for State Medicaid Agencies within Pascoag that year.

Within this category, a small set of individual billing codes accounted for the bulk of Medicaid payments.

Between 2024 and 2023, Medicaid payments in Pascoag tied to National Codes Established for State Medicaid Agencies increased 21.2%, compared to a 0.6% change across all Medicaid categories in the city during the same period.

The Centers for Medicare & Medicaid Services report that combined federal and state Medicaid outlays reached about $871.7 billion in fiscal 2023, making up approximately 18% of total national health spending. That figure represents a substantial rise from roughly $613.5 billion in 2019, before the COVID-19 pandemic.

This increase marks approximately 40% growth in just a few years, driven mainly by expanded enrollment and greater service use during and after the pandemic years.

New federal budget laws under the Trump administration have featured major proposals for curbing federal Medicaid spending and restructuring the program. The “One Big Beautiful Bill Act,” signed in 2025, is projected to reduce federal Medicaid spending by over $1 trillion in the next decade. It adds policies such as work requirements and higher cost-sharing, which could limit coverage and reduce funding for certain beneficiaries. These measures are expected to shift more costs to states and constrain federal Medicaid growth, even as the program remains a crucial source of health coverage for millions.

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.