Paterson sees 2.4% increase in Medicaid payments for National Codes Established for State Medicaid Agencies in 2024

In 2024, Medicaid providers in Paterson billed $28,087,711 for services classified under the National Codes Established for State Medicaid Agencies category, according to information from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 2.4% rise compared with 2023, when providers submitted $27,434,550 in claims for this service category.

Medicaid, a public health insurance program managed by states and funded by both federal and state governments, covers low-income people and families, seniors, children, and those with disabilities, making it a major part of the U.S. health care system.

Because Medicaid payments originate from taxpayers, changes in local billing levels indicate how public health care resources are distributed within a community.

The “National Codes Established for State Medicaid Agencies” category includes a set of Medicaid-billed services defined by type of care, using standardized HCPCS and CPT code groupings. Analysts assigned each billing code to one service category based on code prefixes and ranges, keeping related services together, avoiding double counting, and ensuring accurate comparisons over time.

While Medicaid spending rose across several service categories, National Codes Established for State Medicaid Agencies was the second-largest by total Medicaid payments in Paterson during 2024.

Statewide in New Jersey, the National Codes Established for State Medicaid Agencies category also ranked second by total payments for 2024.

During the five-year period leading up to 2024, Medicaid payments linked to the National Codes Established for State Medicaid Agencies category in Paterson grew by $16,172,781, or 135.7%. Some years saw particularly rapid increases, including notable growth in both 2021 and 2022.

Despite spending for this category being distributed across Paterson, payments were concentrated in a select group of ZIP codes. In 2024, ZIP code 07514 saw the highest Medicaid payments at $14,188,500, followed by 07505 at $6,477,243 and 07502 with $5,773,696. The top 3 ZIP codes together made up 94.1% of all Medicaid payments for this category in Paterson for the year.

Payments within the National Codes Established for State Medicaid Agencies category were also focused among a small number of billing codes.

For context, Medicaid payments in this category in Paterson rose 2.4% between 2024 and 2023, compared with a 5.9% increase across all Medicaid claim categories in the city for the period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023, making up about 18% of overall national health expenditures, rising from around $613.5 billion in 2019, before the COVID-19 pandemic.

This reflects an increase of about 40% over a few years, mainly due to greater enrollment and utilization during and after the pandemic.

Federal budget legislation enacted during the Trump administration included major proposals to reduce federal funding for Medicaid and restructure the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid spending by over $1 trillion over the next decade. It also introduces work requirements and greater cost-sharing, potentially lowering coverage and funding for certain beneficiaries. These measures are projected to increase state costs and limit the federal Medicaid funding growth, as the program continues to serve tens of 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.