Medicaid payments for state-defined services in Monticello up 4.5% in 2024

Monticello Medicaid providers billed $825,133 for services listed under the National Codes Established for State Medicaid Agencies in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This was a 4.5% increase compared to 2023, when $789,461 in claims were submitted for this service category.

Medicaid is a public health insurance program administered by the states and funded jointly by federal and state governments. The program covers low-income individuals and families, children, seniors and those with disabilities, making it a major component of the U.S. health care system.

Since Medicaid payments are funded by taxpayers, shifts in local billing rates indicate how public health dollars are spent in the community.

The “National Codes Established for State Medicaid Agencies” category includes a range of Medicaid-billed services defined by the type of care, grouped using standardized HCPCS and CPT coding. Each billing code for this analysis was linked to a specific service category using uniform code prefixes and numeric ranges, so related services could be analyzed together, avoiding duplicate counting and ensuring accurate comparisons over time.

While Medicaid spending increased in several service categories, National Codes Established for State Medicaid Agencies placed third among all Medicaid payment categories in Monticello in 2024.

Statewide in New York, the National Codes Established for State Medicaid Agencies category was the leading category for Medicaid payments in 2024.

Medicaid payments for the National Codes Established for State Medicaid Agencies category in Monticello grew by $97,519, or 13.4%, over the five years ending in 2024. Periods of accelerated growth occurred in 2020 and 2023 with marked annual increases.

Although payments for care in the National Codes Established for State Medicaid Agencies category were spread across Monticello, the highest dollar amounts were concentrated in a small number of ZIP codes. In 2024, ZIP code 12701 saw the entire $825,133 in Medicaid payments for National Codes Established for State Medicaid Agencies, making up 100% of spending in this category within the city that year.

Within this service classification, Medicaid payments were also focused among just a few individual billing codes.

Comparatively, payments for the National Codes Established for State Medicaid Agencies category in Monticello went up 4.5% between 2024 and 2023. This increase was below the 7.4% change across all Medicaid claim categories in the city during the same period.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures reached about $871.7 billion in fiscal 2023—roughly 18% of national health spending—up from $613.5 billion in 2019, prior to the COVID-19 pandemic.

The change marks an approximate 40% increase in several years, mainly fueled by growth in Medicaid enrollment and service use during and after the pandemic.

Recent federal budget actions under the Trump administration have brought proposals for significant federal Medicaid reductions and program restructuring. The “One Big Beautiful Bill Act,” signed into law in 2025, is anticipated to reduce federal Medicaid outlays by over $1 trillion in the next decade and introduces provisions such as work requirements and higher cost-sharing. These changes may limit federal Medicaid funding and shift more financial responsibility to states, as the program keeps serving millions of Americans.

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.