In 2024, Medicaid providers in Elizabethtown submitted $20,261,195 in claims for services categorized as National Codes Established for State Medicaid Agencies, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount was a 0.6% rise from 2023, when $20,134,888 was billed for the same set of services.
Medicaid is a publicly funded health insurance program managed at the state level and financed in partnership by the federal and state governments. It serves individuals and families with low incomes, seniors, children, and people with disabilities, making it a significant part of the U.S. health system.
Since Medicaid spending is taxpayer funded, shifts in billing at the local level reflect changes in the allocation of public health care resources.
The National Codes Established for State Medicaid Agencies category is defined by groupings of Medicaid services based on standardized HCPCS and CPT codes. For this analysis, each billing code has been placed in a single service category using consistent prefixes and ranges, allowing analysts to track related services over time, avoid duplication, and maintain rank accuracy.
Medicaid spending grew across a variety of service areas, with National Codes Established for State Medicaid Agencies holding the third spot for total Medicaid payments in Elizabethtown during 2024.
Across Kentucky, the National Codes Established for State Medicaid Agencies category topped all others for total Medicaid payments statewide in 2024.
Between 2019 and 2024, Elizabethtown saw Medicaid payments for the National Codes Established for State Medicaid Agencies category grow by $3,338,048, or 19.7%. Periods of faster growth were evident, most notably in 2023 and 2022, with significant increases year over year.
Although services in this category were billed throughout the city, Medicaid payments were focused within a small number of ZIP codes. In 2024, ZIP code 42701 alone contributed $20,261,194, accounting for 100% of Medicaid payments in this service category in Elizabethtown.
Within the National Codes Established for State Medicaid Agencies, most Medicaid payments were tied to just a few billing codes.
In Elizabethtown, Medicaid spending for National Codes Established for State Medicaid Agencies increased by 0.6% from 2023 to 2024, compared to a 0.5% change across all Medicaid categories locally for the same time frame.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures rose to about $871.7 billion in fiscal 2023, making up around 18% of total national health expenditures. This reflects a significant increase from approximately $613.5 billion in 2019, before the COVID-19 pandemic.
This rise equates to roughly 40% growth over several years, largely attributed to heightened enrollment and increased health service usage during and following the pandemic.
Recent federal budget laws under the Trump administration contained major measures that target reducing federal Medicaid funding and restructuring the system. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to decrease federal Medicaid spending by more than $1 trillion in the next decade, and incorporates policies such as work requirements and higher cost-sharing, which could limit coverage and decrease funding for certain groups. These updates are set to pass more financial responsibility to states and restrain growth in federal Medicaid support, while the program continues to serve tens of millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $16,923,147 | -4.3% |
| 2021 | $17,094,105 | 1% |
| 2022 | $18,349,436 | 7.3% |
| 2023 | $20,134,887 | 9.7% |
| 2024 | $20,261,194 | 0.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $49,168,355 | 34.5% |
| 2 | Medicine Services and Procedures | $29,609,237 | 20.8% |
| 3 | National Codes Established for State Medicaid Agencies | $20,261,194 | 14.2% |
| 4 | Evaluation and Management | $14,245,471 | 1<0.1% |
| 5 | Temporary National Codes (Non-Medicare) | $10,936,456 | 7.7% |
| 6 | Radiology Procedures | $7,538,186 | 5.3% |
| 7 | Pathology and Laboratory Procedures | $4,354,917 | 3.1% |
| 8 | Surgery | $2,257,653 | 1.6% |
| 9 | Durable Medical Equipment | $728,312 | 0.5% |
| 10 | Outpatient PPS | $613,178 | 0.4% |
| 11 | Ambulance and Other Transport Services and Supplies | $523,807 | 0.4% |
| 12 | Drugs Administered Other than Oral Method | $509,004 | 0.4% |
| 13 | Procedures / Professional Services | $490,248 | 0.3% |
| 14 | Dental Services | $405,564 | 0.3% |
| 15 | Medical And Surgical Supplies | $320,230 | 0.2% |
| 16 | Vision Services | $271,070 | 0.2% |
| 17 | Administrative, Miscellaneous and Investigational | $82,643 | 0.1% |
| 18 | Temporary Codes | $80,194 | 0.1% |
| 19 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $20,343 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $5,822,122 | 24 |
| T2016 | Habil res waiver per diem | $3,785,718 | 12 |
| T2023 | Targeted case mgmt per month | $3,633,670 | 196 |
| T2022 | Case management, per month | $2,299,607 | 29 |
| T2040 | Financial mgt waiver/15min | $2,034,613 | 39 |
| T2021 | Day habil waiver per 15 min | $1,692,434 | 12 |
| T1005 | Respite care service 15 min | $886,942 | 24 |
| T1007 | Treatment plan development | $60,497 | 44 |
| T1016 | Case management | $34,650 | 11 |
| T2005 | N-et; stretcher van | $10,937 | 11 |
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.
