In 2024, Germantown Medicaid providers billed a total of $314,488 for services under the National Codes Established for State Medicaid Agencies category, as reported by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects a 51.1% rise compared with 2023, when $208,171 in claims were submitted for the same classification.
Medicaid serves as a state-administered public health insurance program, funded by both state and federal governments. The program covers eligible low-income individuals, families, seniors, children, and people with disabilities, making it a major component of the U.S. health care landscape.
Because Medicaid is funded by taxpayers, fluctuation in local billing amounts reflects shifts in how community health care resources are distributed.
The “National Codes Established for State Medicaid Agencies” grouping includes Medicaid-billed services identified by the type of care, structured using standardized HCPCS and CPT code classifications. Each service code was assigned to one category based on code prefixes and ranges for this analysis, allowing for group-level comparisons without double counting and ensuring accuracy in tracking annual trends.
While Medicaid expenditures rose across several categories, National Codes Established for State Medicaid Agencies was ranked eighth for total Medicaid payments in Germantown for 2024.
At the state level in Tennessee, National Codes Established for State Medicaid Agencies was the leading category by total Medicaid payments in 2024.
From 2019 through 2024, Medicaid payments linked to the National Codes Established for State Medicaid Agencies in Germantown grew by $310,051, or 6987.8%. The rate of spending growth saw notable gains in certain years, including substantial year-to-year increases in 2022 and 2023.
Despite citywide distribution, these payments were concentrated in a few ZIP codes. In 2024, ZIP code 38138 comprised $314,488 in Medicaid payments for these services, meaning the top ZIP code represented 100% of such Medicaid spending in Germantown for the year.
Within this Medicaid service category, payments were also focused among a small number of individual billing codes.
For context, Germantown’s Medicaid payments for the National Codes Established for State Medicaid Agencies category climbed by 51.1% from 2023 to 2024, in comparison to a 30.7% increase across all Medicaid categories in the city during the same span.
Centers for Medicare & Medicaid Services data shows combined federal and state Medicaid spending reached about $871.7 billion in fiscal year 2023, amounting to nearly 18% of total U.S. health expenditures, a notable rise from $613.5 billion in 2019, before the COVID-19 pandemic.
This increase represents an approximately 40% rise over several years, largely attributed to greater enrollment and increased service use during and after the pandemic period.
Recent federal budget legislation during the Trump administration included measures aimed at cutting federal Medicaid funding and restructuring the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by over $1 trillion over 10 years and implements policies such as work requirements and greater cost-sharing, potentially reducing coverage and funds for certain individuals. These adjustments are predicted to shift more responsibilities to states and restrict federal Medicaid growth, even as the program continues serving millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $4,437 | -23.9% |
| 2021 | $3,993 | -10% |
| 2022 | $37,758 | 845.4% |
| 2023 | $208,171 | 451.3% |
| 2024 | $314,488 | 51.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $4,641,207 | 30.5% |
| 2 | Medical And Surgical Supplies | $2,865,318 | 18.8% |
| 3 | Radiology Procedures | $2,312,588 | 15.2% |
| 4 | Medicine Services and Procedures | $2,073,645 | 13.6% |
| 5 | Administrative, Miscellaneous and Investigational | $1,636,994 | 10.7% |
| 6 | Durable Medical Equipment | $461,089 | 3% |
| 7 | Surgery | $443,382 | 2.9% |
| 8 | National Codes Established for State Medicaid Agencies | $314,488 | 2.1% |
| 9 | Pathology and Laboratory Procedures | $247,014 | 1.6% |
| 10 | Procedures / Professional Services | $95,087 | 0.6% |
| 11 | Ambulance and Other Transport Services and Supplies | $44,416 | 0.3% |
| 12 | Temporary National Codes (Non-Medicare) | $28,031 | 0.2% |
| 13 | Chemotherapy Drugs | $27,851 | 0.2% |
| 14 | Orthotic Procedures and services | $22,661 | 0.1% |
| 15 | Drugs Administered Other than Oral Method | $12,477 | 0.1% |
| 16 | Temporary Codes | $8,868 | 0.1% |
| 17 | Vision Services | $475 | <0.1% |
| 18 | Anesthesia | $0 | <0.1% |
| 18 | Outpatient PPS | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T4541 | Large disposable underpad | $56,842 | 12 |
| T4543 | Adult disp brief/diap abv xl | $47,818 | 11 |
| T4534 | Youth size pull-on | $40,193 | 12 |
| T4528 | Adult size pull-on xl | $39,894 | 12 |
| T4527 | Adult size pull-on lg | $31,922 | 12 |
| T4526 | Adult size pull-on med | $23,916 | 11 |
| T4524 | Adult size brief/diaper xl | $22,663 | 12 |
| T4523 | Adult size brief/diaper lg | $14,835 | 11 |
| T4522 | Adult size brief/diaper med | $12,480 | 10 |
| T4530 | Ped size brief/diaper lg | $11,226 | 12 |
| T4535 | Disposable liner/shield/pad | $8,404 | 12 |
| T4537 | Reusable underpad bed size | $2,803 | 11 |
| T1015 | Clinic service | $1,486 | 4 |
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.
