Jackson Medicaid providers billed $36,503,132 in 2024 for services within 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 total reflects a 173.3% increase from 2023, when claims for the same service type reached $13,355,719.
Medicaid, a state-operated health insurance program jointly funded by federal and state governments, provides coverage to low-income individuals and families, children, seniors, and people with disabilities, making it a major component of the U.S. health care system. More information is available at the Commonwealth Fund.
Because Medicaid funding is derived from taxpayers, shifts in local billing patterns illustrate how public health care resources are distributed within a region.
The “National Codes Established for State Medicaid Agencies” category comprises a standardized set of Medicaid services determined by specific HCPCS and CPT code groupings. For this review, billing codes were grouped into one service category using consistent code prefixes and number ranges to prevent duplicate counts and allow for accurate year-over-year comparisons.
While Medicaid spending increased across several service areas, National Codes Established for State Medicaid Agencies represented Jackson’s highest Medicaid payment category in 2024.
Statewide, this category also ranked first in Tennessee for total Medicaid payments in 2024.
Between 2019 and 2024, Medicaid payments linked to the National Codes Established for State Medicaid Agencies category in Jackson rose by $29,367,995, representing a 411.6% growth. Notable spikes occurred in 2020 and 2022, accelerating the upward spending trend.
Although claims in the National Codes Established for State Medicaid Agencies category were recorded citywide, payments were concentrated in a few ZIP codes. For 2024, ZIP code 38305 accounted for $27,704,373, and ZIP code 38301 added $8,798,758; combined, these 2 ZIP codes represented 100% of all related Medicaid payments in Jackson for the year.
Inside the National Codes Established for State Medicaid Agencies category, a small number of billing codes accounted for most Medicaid payments.
For context, Medicaid payments in Jackson tied to this category jumped 173.3% from 2023 to 2024. Across all Medicaid claim types during the same period, the city saw an 18.6% change.
According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid spending was about $871.7 billion for fiscal 2023, equal to roughly 18% of all national health expenditures—an increase from approximately $613.5 billion in 2019, prior to the COVID-19 pandemic.
This rise equates to about 40% growth in just a few years, driven by greater enrollment and utilization during the pandemic and in its aftermath.
Recent federal budget measures under the Trump administration have proposed significant cuts to federal Medicaid funding and program restructuring. The “One Big Beautiful Bill Act,” became law in 2025 and is expected to reduce federal Medicaid outlays by more than $1 trillion over 10 years, with new policies such as work requirements and increased cost-sharing that may affect beneficiary coverage and funding. These policy changes are anticipated to shift more financial responsibility to states and slow federal Medicaid support growth, even as the program continues serving many Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $7,135,137 | 140.1% |
| 2021 | $7,669,082 | 7.5% |
| 2022 | $10,885,525 | 41.9% |
| 2023 | $13,355,718 | 22.7% |
| 2024 | $36,503,131 | 173.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $36,503,131 | 51.6% |
| 2 | Evaluation and Management | $11,914,006 | 16.8% |
| 3 | Temporary National Codes (Non-Medicare) | $5,942,304 | 8.4% |
| 4 | Medicine Services and Procedures | $5,481,494 | 7.7% |
| 5 | Alcohol and Drug Abuse Treatment | $3,450,735 | 4.9% |
| 6 | Radiology Procedures | $1,928,072 | 2.7% |
| 7 | Ambulance and Other Transport Services and Supplies | $1,921,194 | 2.7% |
| 8 | Pathology and Laboratory Procedures | $743,671 | 1.1% |
| 9 | Surgery | $591,632 | 0.8% |
| 10 | Durable Medical Equipment | $524,259 | 0.7% |
| 11 | Dental Services | $352,619 | 0.5% |
| 12 | Medical And Surgical Supplies | $307,534 | 0.4% |
| 13 | Anesthesia | $247,356 | 0.3% |
| 14 | Procedures / Professional Services | $224,266 | 0.3% |
| 15 | Vision Services | $204,382 | 0.3% |
| 16 | Orthotic Procedures and services | $190,379 | 0.3% |
| 17 | Enteral and Parenteral Therapy | $123,473 | 0.2% |
| 18 | Drugs Administered Other than Oral Method | $78,511 | 0.1% |
| 19 | Administrative, Miscellaneous and Investigational | $29,077 | <0.1% |
| 20 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $28,031 | <0.1% |
| 21 | Prosthetic Procedures | $3,243 | <0.1% |
| 22 | Diagnostic Radiology Services | $3,168 | <0.1% |
| 23 | Temporary Codes | $2,141 | <0.1% |
| 24 | Other Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2033 | Res, nos waiver per diem | $24,357,645 | 42 |
| T1019 | Personal care ser per 15 min | $5,297,326 | 40 |
| T2021 | Day habil waiver per 15 min | $3,491,522 | 30 |
| T2048 | Bh ltc res r&b, per diem | $1,733,198 | 10 |
| T2025 | Waiver service, nos | $741,050 | 5 |
| T2030 | Assist living waiver/month | $426,304 | 11 |
| T2029 | Special med equip, noswaiver | $158,849 | 12 |
| T2046 | Hospice long term care, r&b | $127,965 | 2 |
| T2019 | Habil sup empl waiver 15min | $123,911 | 7 |
| T2002 | N-et; per diem | $36,156 | 12 |
| T2005 | N-et; stretcher van | $6,868 | 7 |
| T2049 | N-et; stretcher van, mileage | $2,333 | 7 |
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.
