In 2024, Medicaid providers in Spring Valley submitted $74,057,905 in claims for services categorized under the National Codes Established for State Medicaid Agencies, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total marks a 0.1% rise from 2023, when $73,952,941 was billed for these services.
Medicaid is publicly funded and administered by states with financial support from both federal and state governments. The program provides coverage for people with low incomes, older adults, children, and individuals with disabilities, comprising a substantial portion of the national health care system.
As Medicaid payments are supported by taxpayer funds, variations in local billing reflect changes in how community health resources are distributed.
The National Codes Established for State Medicaid Agencies category represents a defined set of Medicaid services, grouped by the type of care according to standardized HCPCS and CPT codes. This analysis assigns each code to a unique service category using matching prefixes and number ranges, which helps group comparable services together and avoids counting the same service more than once, supporting accurate trends and rankings over time.
The National Codes Established for State Medicaid Agencies ranked as the top Medicaid service category in Spring Valley by total payments for 2024, continuing its lead among service categories.
Statewide, New York also saw the National Codes Established for State Medicaid Agencies category rank first by total Medicaid payments for the year 2024.
Looking at the five years before 2024, Medicaid payments in Spring Valley for this category grew by $5,784,836, an 8.5% increase. This growth was especially prominent in some years, such as 2020 and 2023, which recorded notable year-over-year jumps.
The spending for this Medicaid category, while distributed citywide, was primarily focused in a small number of ZIP codes. For 2024, ZIP code 10977 accounted for $74,057,904 of the payments—making up 100% of this service category’s Medicaid billing in Spring Valley that year.
Within the National Codes Established for State Medicaid Agencies, payments were further concentrated among only a few billing codes.
Between 2024 and 2023, Spring Valley’s Medicaid payments for this category rose 0.1%, compared with an increase of 9% across all Medicaid categories in the city for the same timeframe.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached about $871.7 billion in fiscal year 2023, representing roughly 18% of nationwide health expenditures. This is a sharp increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This growth equals an increase of around 40% in just a few years, driven largely by higher enrollment and greater use of services linked to the pandemic and its aftermath.
Recent federal budget measures from the Trump administration have featured major proposals to reduce federal support for Medicaid and revamp the program’s structure. For example, the “One Big Beautiful Bill Act,” signed in 2025, is estimated to reduce federal Medicaid outlays by more than $1 trillion over the next decade, and introduces changes such as work requirements and higher cost-sharing, potentially affecting benefits and eligibility for some participants. These reforms may transfer increased costs to the states and restrict the rate of federal Medicaid spending growth, even as Medicaid continues to serve tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $68,273,068 | 44.9% |
| 2021 | $66,372,875 | -2.8% |
| 2022 | $65,040,496 | -2% |
| 2023 | $73,952,940 | 13.7% |
| 2024 | $74,057,904 | 0.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $74,057,904 | 64.3% |
| 2 | Alcohol and Drug Abuse Treatment | $16,454,754 | 14.3% |
| 3 | Medicine Services and Procedures | $8,491,331 | 7.4% |
| 4 | Evaluation and Management | $4,808,062 | 4.2% |
| 5 | Surgery | $3,047,010 | 2.6% |
| 6 | Dental Services | $2,412,267 | 2.1% |
| 7 | Temporary National Codes (Non-Medicare) | $1,827,955 | 1.6% |
| 8 | Radiology Procedures | $1,465,154 | 1.3% |
| 9 | Vision Services | $1,430,123 | 1.2% |
| 10 | Ambulance and Other Transport Services and Supplies | $827,426 | 0.7% |
| 11 | Medical And Surgical Supplies | $165,405 | 0.1% |
| 12 | Pathology and Laboratory Procedures | $102,150 | 0.1% |
| 13 | Administrative, Miscellaneous and Investigational | $26,903 | <0.1% |
| 14 | Enteral and Parenteral Therapy | $10,878 | <0.1% |
| 15 | Orthotic Procedures and services | $3,600 | <0.1% |
| 16 | Procedures / Professional Services | $3,350 | <0.1% |
| 17 | Drugs Administered Other than Oral Method | $2,889 | <0.1% |
| 18 | Durable Medical Equipment | $1,598 | <0.1% |
| 19 | Temporary Codes | $854 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $72,027,314 | 24 |
| T1020 | Personal care ser per diem | $1,460,029 | 11 |
| T2015 | Habil prevoc waiver per hr | $333,726 | 10 |
| T1022 | Contracted services per day | $89,686 | 3 |
| T1015 | Clinic service | $85,659 | 10 |
| T4533 | Youth size brief/diaper | $50,655 | 12 |
| T1017 | Targeted case management | $5,160 | 7 |
| T1013 | Sign lang/oral interpreter | $3,117 | 11 |
| T2003 | N-et; encounter/trip | $2,043 | 1 |
| T1030 | Rn home care per diem | $512 | 1 |
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.
