Addison sees 19.9% growth in Medicaid payments linked to National Codes Established for State Medicaid Agencies in 2024

In 2024, Medicaid providers in Addison billed $1,336,565 for services falling under National Codes Established for State Medicaid Agencies, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 19.9% increase compared to 2023, when claims for the same set of services totaled $1,115,011.

Medicaid is a public health insurance program managed by individual states with funding from both federal and state governments. The program provides coverage for eligible low-income residents, including families, older adults, children, and people with disabilities, making it one of the country's largest components of health care.

As Medicaid funding comes from taxpayer dollars, shifts in local billing help illustrate how public health funds are distributed within a community.

The "National Codes Established for State Medicaid Agencies" category refers to a set of Medicaid-billed services based on standardized HCPCS and CPT code groupings determined by the type of care delivered. For this report, billing codes were assigned to a specific service group using consistent code prefixes and number ranges, ensuring related services were reviewed collectively, double counting was avoided, and rankings remained accurate over time.

While Medicaid expenditures increased in several service categories, National Codes Established for State Medicaid Agencies was the second-largest category by total Medicaid payments in Addison for 2024.

Across Illinois, National Codes Established for State Medicaid Agencies led all categories by total Medicaid payments in 2024.

Over the five years through 2024, Medicaid payments tied to the National Codes Established for State Medicaid Agencies in Addison rose by $349,797, or 20.7%. This upward trend saw periods of accelerated growth, with particularly strong increases during 2023 and 2021.

Payments for services in the National Codes Established for State Medicaid Agencies category were distributed citywide, but concentrated in just a handful of ZIP codes. In 2024, ZIP code 60101 accounted for $1,336,565 in Medicaid payments for this category, meaning the top ZIP code represented 100% of local Medicaid payments for National Codes Established for State Medicaid Agencies in Addison during the year.

Within this category, the bulk of Medicaid payments was focused on a small group of billing codes.

To put Addison's figures in perspective, Medicaid payments tied to National Codes Established for State Medicaid Agencies grew by 19.9% from 2023 to 2024, while overall Medicaid claim payments in the city rose by 31.3% across all categories in the same timeframe.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending was about $871.7 billion in fiscal year 2023, making up approximately 18% of total national health expenditures. This is a significant increase from $613.5 billion in 2019, before the COVID-19 pandemic.

That surge equals nearly 40% growth in just a few years, largely due to expanded Medicaid enrollments and increased service utilization during and after the pandemic period.

Recent federal budget changes enacted during the Trump administration have included major proposals to scale back federal Medicaid funding and reshape the program. The “One Big Beautiful Bill Act,” signed in 2025, is projected to reduce federal Medicaid funding by over $1 trillion in the next decade and to add policies such as work requirements and increased cost-sharing, which could reduce coverage and funding for some Medicaid recipients. These adjustments are expected to place a larger share of expenses on states and limit growth in federal Medicaid assistance, even as the program continues serving 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.