Poca Medicaid spending on state-designated national codes rises to $637,264 in 2024

In 2024, Poca’s Medicaid providers submitted $637,264 in claims under the National Codes Established for State Medicaid Agencies category, information from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represented an 11.1% rise compared to 2023, when claims for this category totaled $573,819.

Medicaid is a public health insurance system, operated by states and financed through federal and state government partnership. The program supports low-income people, seniors, children, and those with disabilities, and is one of the primary elements of the U.S. health care landscape.

Because Medicaid outlays are taxpayer-funded, variations in local billing reflect how community health care budgets are spent.

The “National Codes Established for State Medicaid Agencies” category organizes Medicaid-billed services according to the care type, using standardized HCPCS and CPT code series. In the analysis, codes are placed within a single service group based on prefixes and ranges to analyze related services together accurately and maintain robust year-over-year comparisons.

While Medicaid outlays increased in several service groupings, the National Codes Established for State Medicaid Agencies category recorded the highest total payments in Poca during 2024.

Across West Virginia, this category also received the highest total Medicaid payments statewide in 2024.

From 2019 to 2024, Poca’s Medicaid payments attributed to this service category rose $439,068, a gain of 221.5%. Growth was particularly strong in certain years, with significant jumps reported in 2021 and 2020.

Spending within this codes category, though present throughout the city, was focused in select ZIP codes. In 2024, payments tied to the National Codes Established for State Medicaid Agencies category were greatest in ZIP code 25011, which totaled $637,263. The top ZIP code contributed 100% of the category’s Medicaid disbursements in Poca that year.

Payments within the service category were also concentrated among a few specific billing codes.

For further perspective, Poca saw an 11.1% increase in Medicaid payments for the state Medicaid agencies’ codes category from 2023 to 2024, whereas overall Medicaid claims citywide grew 6.1% in the same timeframe.

The Centers for Medicare & Medicaid Services reported that combined state and federal spending for Medicaid was about $871.7 billion in the 2023 fiscal year, about 18% of total national medical outlays, and much higher than the approximately $613.5 billion spent in 2019 prior to the COVID-19 pandemic.

This increase amounts to around 40% growth in a few years, mostly due to broader participation and increased medical service usage during and after the pandemic.

Recent national budget laws enacted during the Trump administration have contained significant measures aiming to scale back federal Medicaid spending and restructure the program. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, introduces over $1 trillion in reductions across a decade, adding provisions such as work requirements and enhanced cost-sharing, which may reduce access and available funding for certain beneficiaries. These shifts are expected to require states to shoulder more costs and could constrain future federal Medicaid contributions, even as the program remains vital for tens of millions across the country.

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.