Carol Stream Medicaid payments for national codes surpass $614,000 in 2024

Providers in Carol Stream billed $614,473 to Medicaid in 2024 for services listed under the National Codes Established for State Medicaid Agencies category, figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This total marks a 13.1% rise over 2023, when billings for these services reached $543,207.

Medicaid, a state-run program funded together by federal and state governments, serves low-income individuals and families, seniors, children, and people with disabilities. It is a central part of the U.S. health care system.

Shifts in local Medicaid billing patterns point to how public health resources are distributed within the community.

The “National Codes Established for State Medicaid Agencies” category includes groupings of Medicaid-billed services defined by the type of care—using HCPCS and CPT code clusters. For this reporting, each billing code falls into a specific service category, based on these standardized code sequences, to ensure accurate rankings and avoid totaling the same service twice.

Spending in this category was third highest among all Medicaid service classifications in Carol Stream in 2024.

Statewide in Illinois, National Codes Established for State Medicaid Agencies accounted for the largest total in 2024 Medicaid payments.

Between 2019 and 2024, Medicaid outlays associated with the National Codes Established for State Medicaid Agencies category in Carol Stream increased $62,412, or 11.3%. The pace of spending picked up in some years, notably increasing year over year in both 2023 and 2022.

Local spending for this category was not uniform; while payments were registered throughout the city, most were concentrated in select ZIP codes. In 2024, code 60188 saw Medicaid payments for these services total $614,473, representing 100% of the city’s Medicaid expenditures in this category.

Payments in the National Codes Established for State Medicaid Agencies category also focused largely on a select group of individual billing codes.

Across all Medicaid claim types in Carol Stream, payments increased by 14.5% between 2023 and 2024, just above the 13.1% rise for the national codes category during the same period.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures reached about $871.7 billion in fiscal year 2023, about 18% of total national health spending, sharply up from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.

This increase totals about 40% over a few years, mainly as a result of expanded enrollment and greater care utilization during and after the pandemic.

Legislation during the Trump administration recently included major proposals that would reduce federal Medicaid support and change the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is set to cut at least $1 trillion in federal Medicaid spending over 10 years, adding work requirements and higher cost-sharing that could affect certain beneficiaries’ eligibility and funding. These policies are likely to shift more cost responsibility to states and restrain the rate of federal support even as Medicaid aids 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.