In 2024, Medicaid providers in Arlington submitted $8,891,494 in claims for services listed 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 amount reflects a 1.5% increase from 2023, when $8,761,797 was billed for these services.
The Medicaid program is a state-administered public health insurance initiative supported by both federal and state government funding. It provides coverage to people with low incomes, older adults, children, and individuals with disabilities, representing a major segment of the U.S. health care landscape.
Because Medicaid spending is taxpayer-funded, fluctuations in city-level billing shed light on how public health care resources are distributed locally.
The “National Codes Established for State Medicaid Agencies” category groups Medicaid-billed services by the type of care delivered, categorized through standard HCPCS and CPT code groupings. In conducting this analysis, each code was classified into a single service category, relying on specific code prefixes and numeric ranges. This method avoided duplication and enhanced the accuracy of long-term rankings.
Spending on Medicaid climbed across several service categories, with National Codes Established for State Medicaid Agencies finishing third in Arlington for total payments during 2024.
Statewide in Virginia, this category saw the highest overall Medicaid payments in 2024.
During the five years ending in 2024, Medicaid billing in Arlington for the National Codes Established for State Medicaid Agencies category grew by $4,289,435, a 93.2% increase. Some years saw especially sharp growth, including notable jumps in both 2023 and 2022.
Spending linked to this Medicaid category was not evenly distributed across Arlington; instead, the highest payments were recorded in a handful of ZIP codes. For 2024, ZIP code 22204 topped the list with $5,527,390, followed by 22203 with $3,151,353, and 22209 with $212,750. Altogether, these top 3 ZIP codes represented 100% of payments for this Medicaid category in Arlington that year.
Most Medicaid reimbursements in the National Codes Established for State Medicaid Agencies category were concentrated within a small set of billing codes.
Claims related to this category in Arlington rose 1.5% from 2023 to 2024, while all Medicaid claims in the area increased by 11.3% over that period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures reached roughly $871.7 billion in fiscal year 2023—about 18% of total U.S. health spending and up from $613.5 billion in 2019, before the COVID-19 pandemic.
This jump equates to an increase of around 40% in several years, largely tied to expanded access and greater use during and after the pandemic.
In recent years, federal budget actions during the Trump administration included proposals to reduce federal Medicaid spending and change program structure. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, plans to trim more than $1 trillion from federal Medicaid funding in the coming decade and introduces elements like work requirements and higher cost-sharing that could lead to reduced coverage and state funding. These measures are poised to increase the responsibility of states while limiting the expansion of federal support, even as Medicaid continues to serve millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $4,602,058 | 4.1% |
| 2021 | $5,248,491 | 14% |
| 2022 | $6,443,928 | 22.8% |
| 2023 | $8,761,796 | 36% |
| 2024 | $8,891,493 | 1.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $18,819,356 | 33.7% |
| 2 | Alcohol and Drug Abuse Treatment | $16,222,063 | 29.1% |
| 3 | National Codes Established for State Medicaid Agencies | $8,891,493 | 15.9% |
| 4 | Medicine Services and Procedures | $4,193,597 | 7.5% |
| 5 | Radiology Procedures | $2,607,074 | 4.7% |
| 6 | Pathology and Laboratory Procedures | $1,715,503 | 3.1% |
| 7 | Temporary National Codes (Non-Medicare) | $1,092,997 | 2% |
| 8 | Procedures / Professional Services | $986,147 | 1.8% |
| 9 | Surgery | $924,565 | 1.7% |
| 10 | Ambulance and Other Transport Services and Supplies | $231,873 | 0.4% |
| 11 | Vision Services | $53,337 | 0.1% |
| 12 | Drugs Administered Other than Oral Method | $40,806 | 0.1% |
| 13 | Outpatient PPS | $14,582 | <0.1% |
| 14 | Temporary Codes | $11,196 | <0.1% |
| 15 | Pathology and Laboratory Services | $1,725 | <0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $1,578 | <0.1% |
| 17 | Medical And Surgical Supplies | $252 | <0.1% |
| 18 | Dental Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $7,040,038 | 36 |
| T1005 | Respite care service 15 min | $881,234 | 31 |
| T1017 | Targeted case management | $559,413 | 10 |
| T2023 | Targeted case mgmt per month | $334,824 | 16 |
| T2022 | Case management, per month | $74,992 | 17 |
| T1027 | Family training & counseling | $990 | 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.
