Columbus Medicaid providers billed a total of $170,262,747 for services listed under the National Codes Established for State Medicaid Agencies category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure reflects a 104% jump from 2023, when claims for the same service category reached $83,442,381.
Medicaid is managed on a state level and receives joint funding from federal and state sources. The program offers coverage to individuals and families with low income, seniors, children, and people with disabilities, establishing itself as a significant element of the U.S. health care landscape. For more information, visit this explainer.
Since Medicaid programs are funded with taxpayer dollars, shifts in local billing shed light on how health care resources are distributed in specific communities.
The “National Codes Established for State Medicaid Agencies” group encompasses a range of Medicaid services categorized by care type and organized by standardized HCPCS and CPT code groupings. In this report, each billing code was associated uniquely with a single service category, utilizing designated code prefixes and number ranges, which allowed for grouping similar services while preventing overlap and ensuring accuracy in ongoing comparisons.
Medicaid spending in Columbus rose in multiple service groups, and National Codes Established for State Medicaid Agencies came in second by total Medicaid billing for the city in 2024.
At the state level in Ohio, National Codes Established for State Medicaid Agencies was the top-ranked category for total Medicaid payments in 2024.
Analyzing the five-year period through 2024, Medicaid outlays for the National Codes Established for State Medicaid Agencies category in Columbus rose by $63,188,127, or 59%. Certain years, like 2020 and 2022, saw particularly strong annual increases.
While these Medicaid dollars were distributed throughout Columbus, payments were notably concentrated in a small set of ZIP codes. In 2024, ZIP codes 43229 ($54,304,982), 43231 ($35,426,532), and 43235 ($13,744,442) recorded the highest payments, accounting for a combined 60.8% of the city’s total Medicaid spending in this service group for the year.
Within this service group, a small subset of billing codes received the majority of Medicaid payments in 2024.
Between 2023 and 2024, Medicaid payments attributed to this category in Columbus climbed 104%, significantly outpacing the overall 6.1% rise across all city Medicaid claim categories for the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending stood at approximately $871.7 billion in fiscal 2023, making up about 18% of all national health care expenditures. This marked an increase from roughly $613.5 billion in 2019, ahead of the COVID-19 pandemic.
This demonstrates nearly 40% growth over several years, fueled in large part by broader enrollment and greater use of services during and after the pandemic.
Recent federal budget measures from the Trump administration have included major proposals altering Medicaid funding at the federal level. The “One Big Beautiful Bill Act,” signed in 2025, is expected to reduce federal Medicaid spending by over $1 trillion in the coming decade, introducing policies like work requirements and increased cost-sharing, which could impact some beneficiaries’ access and states’ coverage obligations. These changes are set to shift more Medicaid costs to the states while federal support grows more slowly, all as the program continues to cover tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $107,074,619 | 11.4% |
| 2021 | $114,888,111 | 7.3% |
| 2022 | $123,466,115 | 7.5% |
| 2023 | $83,442,380 | -32.4% |
| 2024 | $170,262,747 | 104% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $177,456,158 | 17.4% |
| 2 | National Codes Established for State Medicaid Agencies | $170,262,747 | 16.7% |
| 3 | Procedures / Professional Services | $149,127,380 | 14.6% |
| 4 | Alcohol and Drug Abuse Treatment | $132,007,083 | 13% |
| 5 | Medicine Services and Procedures | $124,544,123 | 12.2% |
| 6 | Radiology Procedures | $69,730,866 | 6.8% |
| 7 | Temporary National Codes (Non-Medicare) | $40,352,655 | 4% |
| 8 | Surgery | $33,977,267 | 3.3% |
| 9 | Pathology and Laboratory Procedures | $29,826,718 | 2.9% |
| 10 | Drugs Administered Other than Oral Method | $29,303,642 | 2.9% |
| 11 | Chemotherapy Drugs | $24,656,915 | 2.4% |
| 12 | Ambulance and Other Transport Services and Supplies | $11,938,530 | 1.2% |
| 13 | Dental Services | $7,096,408 | 0.7% |
| 14 | Durable Medical Equipment | $4,633,940 | 0.5% |
| 15 | Enteral and Parenteral Therapy | $3,810,610 | 0.4% |
| 16 | Medical And Surgical Supplies | $2,655,417 | 0.3% |
| 17 | Anesthesia | $1,686,375 | 0.2% |
| 18 | Temporary Codes | $928,092 | 0.1% |
| 19 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $864,385 | 0.1% |
| 20 | Administrative, Miscellaneous and Investigational | $821,138 | 0.1% |
| 21 | Pathology and Laboratory Services | $655,716 | 0.1% |
| 22 | Diagnostic Radiology Services | $548,508 | 0.1% |
| 23 | Orthotic Procedures and services | $491,428 | <0.1% |
| 24 | Vision Services | $426,878 | <0.1% |
| 25 | Outpatient PPS | $367,693 | <0.1% |
| 26 | Coronavirus Diagnostic Panel | $37,952 | <0.1% |
| 27 | Prosthetic Procedures | $7,593 | <0.1% |
| 28 | Hearing Services | $5,869 | <0.1% |
| 29 | EOM (Enhancing Oncology Model) Enhanced Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $129,851,494 | 1,342 |
| T1000 | Private duty/independent nsg | $13,229,458 | 47 |
| T2046 | Hospice long term care, r&b | $8,925,945 | 50 |
| T2031 | Assist living waiver/diem | $4,714,521 | 44 |
| T1015 | Clinic service | $2,781,698 | 828 |
| T2022 | Case management, per month | $1,867,303 | 97 |
| T1002 | Rn services up to 15 minutes | $1,366,218 | 270 |
| T2042 | Hospice routine home care | $1,079,361 | 16 |
| T2029 | Special med equip, noswaiver | $774,871 | 13 |
| T1003 | Lpn/lvn services up to 15min | $639,347 | 165 |
| T2023 | Targeted case mgmt per month | $610,489 | 20 |
| T1001 | Nursing assessment/evaluatn | $530,987 | 446 |
| T4541 | Large disposable underpad | $481,556 | 76 |
| T4527 | Adult size pull-on lg | $454,613 | 53 |
| T4534 | Youth size pull-on | $359,590 | 19 |
| T4526 | Adult size pull-on med | $358,074 | 32 |
| T4528 | Adult size pull-on xl | $340,991 | 34 |
| T1502 | Medication admin visit | $233,833 | 27 |
| T4535 | Disposable liner/shield/pad | $224,572 | 32 |
| T4543 | Adult disp brief/diap abv xl | $191,850 | 16 |
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.
