In 2024, Medicaid providers in Alexandria billed $68,301,957 for services classified under the National Codes Established for State Medicaid Agencies category, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 0.7% increase compared with 2023, when providers filed $67,799,591 in claims in the same category.
Medicaid is a public health insurance program managed by the states and jointly financed by federal and state governments, covering low-income individuals and families, seniors, children and people with disabilities. As one of the largest components of the U.S. health care system, it plays a significant role in providing coverage.
Because Medicaid payments come from taxpayer funding, changes in billing levels at the local level show how public health care resources are distributed in a community.
The National Codes Established for State Medicaid Agencies category encompasses a range of Medicaid-billed services defined by the type of care. These are grouped using standardized HCPCS and CPT code prefixes and numbering, enabling consistent analysis of related services without double counting and ensuring precise ranking over time.
Although Medicaid spending grew in several service categories, National Codes Established for State Medicaid Agencies ranked first in Alexandria for total Medicaid payments in 2024.
For Virginia overall, the National Codes Established for State Medicaid Agencies category was also ranked first by total Medicaid payments in 2024.
Between 2019 and 2024, Medicaid payments for the National Codes Established for State Medicaid Agencies category in Alexandria went up by $19,418,924, or 39.7%. Growth rates varied during this span, with notable year-over-year increases occurring in 2021 and 2020.
Spending within this category was distributed across the city, but the bulk of payments were concentrated in a few ZIP codes. In 2024, ZIP code 22312 had the highest Medicaid payments for this category at $42,472,055, followed by 22304 at $9,604,460, and 22302 at $4,985,977. Combined, these top 3 ZIP codes represented 83.5% of all related Medicaid payments in Alexandria for the year.
Payments were also concentrated among a small set of individual billing codes in the National Codes Established for State Medicaid Agencies category.
To compare, Medicaid payments for this category in Alexandria rose 0.7% from 2024 to 2023, while all Medicaid claim categories in the city saw a 7% change during the same timeframe.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending combined reached about $871.7 billion in fiscal 2023, accounting for about 18% of all U.S. health expenditures. This was a sharp increase from roughly $613.5 billion in 2019 before the COVID-19 pandemic.
This growth equates to an increase of nearly 40% in a few years, mainly due to higher enrollment and more utilization during and following the pandemic.
Federal budget laws under the Trump administration recently included major proposals to cut federal Medicaid funding and modify the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next 10 years. The law also introduces work requirements and greater cost-sharing, which could decrease coverage and funding for some beneficiaries. As a result, more costs may shift to states, and the growth of federal Medicaid support may be limited, even though the program serves many Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $48,883,032 | 12.5% |
| 2021 | $56,118,779 | 14.8% |
| 2022 | $61,991,093 | 10.5% |
| 2023 | $67,799,590 | 9.4% |
| 2024 | $68,301,956 | 0.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $68,301,956 | 57.1% |
| 2 | Evaluation and Management | $19,910,312 | 16.6% |
| 3 | Medicine Services and Procedures | $9,626,973 | 8% |
| 4 | Temporary National Codes (Non-Medicare) | $5,178,613 | 4.3% |
| 5 | Alcohol and Drug Abuse Treatment | $5,146,579 | 4.3% |
| 6 | Radiology Procedures | $4,028,077 | 3.4% |
| 7 | Procedures / Professional Services | $2,476,866 | 2.1% |
| 8 | Surgery | $1,805,669 | 1.5% |
| 9 | Ambulance and Other Transport Services and Supplies | $797,198 | 0.7% |
| 10 | Pathology and Laboratory Procedures | $689,410 | 0.6% |
| 11 | Durable Medical Equipment | $634,534 | 0.5% |
| 12 | Medical And Surgical Supplies | $477,252 | 0.4% |
| 13 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $220,929 | 0.2% |
| 14 | Anesthesia | $169,564 | 0.1% |
| 15 | Vision Services | $90,023 | 0.1% |
| 16 | Drugs Administered Other than Oral Method | $42,092 | <0.1% |
| 17 | Dental Services | $33,631 | <0.1% |
| 18 | Enteral and Parenteral Therapy | $20,896 | <0.1% |
| 19 | Pathology and Laboratory Services | $6,232 | <0.1% |
| 20 | Administrative, Miscellaneous and Investigational | $1,838 | <0.1% |
| 21 | Outpatient PPS | $1,476 | <0.1% |
| 22 | Coronavirus Diagnostic Panel | $681 | <0.1% |
| 23 | Temporary Codes | $232 | <0.1% |
| 24 | Miscellaneous Medical Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $59,429,490 | 207 |
| T1005 | Respite care service 15 min | $6,721,611 | 103 |
| T2003 | N-et; encounter/trip | $782,922 | 44 |
| T2021 | Day habil waiver per 15 min | $739,029 | 22 |
| T4543 | Adult disp brief/diap abv xl | $246,650 | 12 |
| T2005 | N-et; stretcher van | $99,725 | 3 |
| T4524 | Adult size brief/diaper xl | $78,065 | 13 |
| T2022 | Case management, per month | $70,930 | 10 |
| T1017 | Targeted case management | $59,871 | 2 |
| T4535 | Disposable liner/shield/pad | $55,146 | 12 |
| T4523 | Adult size brief/diaper lg | $10,161 | 4 |
| T1028 | Home environment assessment | $5,075 | 2 |
| T2023 | Targeted case mgmt per month | $3,276 | 1 |
| T2049 | N-et; stretcher van, mileage | $0 | 3 |
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.
