Medicaid payments for state-designated codes rise 22.4% in Butler for 2024

In 2024, Butler Medicaid providers billed $3,151,090 for services identified under the National Codes Established for State Medicaid Agencies category, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents an increase of 22.4% from 2023, when claims for these services totaled $2,574,522.

Medicaid is a government health coverage program administered at the state level and funded through a combination of federal and state resources. The program supports low-income residents, seniors, children, and people with disabilities, making it a significant component of the U.S. health care system.

Since Medicaid draws on taxpayer funding, fluctuations in local billing reveal how public health spending is distributed throughout the community.

The “National Codes Established for State Medicaid Agencies” service category includes a collection of Medicaid-charged services defined by specific care types, structured around standardized HCPCS and CPT code groups. Each billing code was assigned to a single service category using uniform code prefixes and numerical groupings, which enables the consistent analysis of related services and ensures rankings are kept accurate while avoiding duplicate calculations over time.

Although Butler saw Medicaid payment increases in several different service categories, National Codes Established for State Medicaid Agencies held third place by total Medicaid expenditures in 2024 for the area.

Statewide in Pennsylvania, this category ranked second in total Medicaid payments during 2024.

Throughout the five years before 2024, Butler’s Medicaid payments identified under the National Codes Established for State Medicaid Agencies category rose by $1,518,707, marking a 93% increase. The rate of spending growth intensified in some years, particularly in 2021 and 2020.

While Medicaid expenditures for this category were distributed across Butler, most payments were concentrated within a small set of ZIP codes. In 2024, ZIP code 16001 reported $2,216,205 in Medicaid payments, and 16002 accounted for $934,884. These two ZIP codes together comprised 100% of Butler’s Medicaid payments linked to this service category for the year.

Analysis shows that Medicaid payments in the National Codes Established for State Medicaid Agencies category were focused among just a handful of billing codes.

To put this change into context, payments tied to this category in Butler climbed 22.4% from 2023 to 2024, whereas all Medicaid claim categories in the city saw a combined rise of 15.4% for that period.

The Centers for Medicare & Medicaid Services reports that combined federal and state Medicaid spending reached approximately $871.7 billion during fiscal 2023—roughly 18% of U.S. health expenditures. This is a major increase compared with $613.5 billion in 2019, prior to the COVID-19 pandemic.

This roughly 40% rise over a short period is primarily attributed to expanded recipient enrollment and increased use of services during and after the pandemic.

Recent federal budget moves during the Trump administration have featured prominent proposals to trim federal Medicaid funding and change the program’s structure. For example, the “One Big Beautiful Bill Act,” which became law in 2025, is projected to reduce federal Medicaid outlays by over $1 trillion in the next decade. The legislation implements measures such as work requirements and higher cost-sharing, which could limit coverage and cut funding for some participants. These policy shifts are expected to transfer more funding responsibility to states and restrain the pace of federal Medicaid growth, even as the program continues to support millions nationally.

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.