In 2024, Medicaid providers billed $5,511,634 in Harrisonburg for services under the National Codes Established for State Medicaid Agencies category, as detailed by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 14.5% rise from 2023, when providers in the area claimed $4,815,392 for the same types of services.
Medicaid operates as a state-administered health insurance program funded collectively by state and federal governments. The program provides coverage for low-income families, seniors, children, and individuals with disabilities, solidifying its role as a core component of health care in the U.S.
Local fluctuations in Medicaid billing reflect how taxpayer-supported dollars for public health care are distributed throughout the community.
The “National Codes Established for State Medicaid Agencies” category includes a set of Medicaid services identified by specific HCPCS and CPT code groups, describing care types. In this analysis, each billing code was assigned to one category using uniform code prefixes and number ranges to group and compare similar services without overlap and to ensure precise year-over-year tracking.
Harrisonburg saw the National Codes Established for State Medicaid Agencies category rank as the second largest by Medicaid payments in 2024, even as spending expanded among other service types.
At the state level, Virginia recorded this category as the highest by total Medicaid payments for 2024.
Medicaid payments connected to the National Codes Established for State Medicaid Agencies category in Harrisonburg rose by $1,519,436 over the five years up to 2024, marking a 38.1% increase. Spending accelerated at various points, notably with strong gains in 2022 and 2021.
These Medicaid payments in 2024 were distributed throughout the city but concentrated within select ZIP codes: 22801 accounted for $3,796,563, and 22802 made up $1,715,070. Combined, these areas represented 100% of Harrisonburg’s Medicaid payments in the category that year.
A small number of billing codes captured most Medicaid payments within this codes category for the period reviewed.
Between 2024 and 2023, Medicaid payments for this category rose 14.5% locally, whereas total Medicaid spending across all service categories in Harrisonburg increased by 12.3% in the same timeframe.
Data from the Centers for Medicare & Medicaid Services shows federal and state spending on Medicaid reached approximately $871.7 billion in fiscal 2023, about 18% of U.S. national health costs, compared with $613.5 billion in 2019 before the pandemic.
The nearly 40% increase was mainly driven by enlarged enrollment and greater service use throughout and following the COVID-19 pandemic.
Federal budget actions enacted during the Trump administration have included proposals to reduce federal Medicaid spending and restructure the program. The “One Big Beautiful Bill Act,” which became law in 2025, is set to cut more than $1 trillion in federal Medicaid spending over 10 years. This act implements work requirements and heightened cost-sharing, potentially reducing coverage and financing for certain enrollees while placing more cost responsibility on states and slowing federal Medicaid growth as the program continues to support millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $3,992,197 | -20.5% |
| 2021 | $4,220,230 | 5.7% |
| 2022 | $5,065,121 | 20% |
| 2023 | $4,815,392 | -4.9% |
| 2024 | $5,511,633 | 14.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $5,858,942 | 23.1% |
| 2 | National Codes Established for State Medicaid Agencies | $5,511,633 | 21.7% |
| 3 | Medicine Services and Procedures | $4,204,142 | 16.6% |
| 4 | Alcohol and Drug Abuse Treatment | $3,836,467 | 15.1% |
| 5 | Radiology Procedures | $2,163,432 | 8.5% |
| 6 | Surgery | $1,199,937 | 4.7% |
| 7 | Procedures / Professional Services | $1,112,136 | 4.4% |
| 8 | Ambulance and Other Transport Services and Supplies | $546,305 | 2.2% |
| 9 | Temporary National Codes (Non-Medicare) | $262,935 | 1% |
| 10 | Durable Medical Equipment | $175,279 | 0.7% |
| 11 | Vision Services | $164,387 | 0.6% |
| 12 | Pathology and Laboratory Procedures | $162,957 | 0.6% |
| 13 | Medical And Surgical Supplies | $103,180 | 0.4% |
| 14 | Drugs Administered Other than Oral Method | $28,618 | 0.1% |
| 15 | Outpatient PPS | $12,673 | <0.1% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $6,516 | <0.1% |
| 17 | Temporary Codes | $3,515 | <0.1% |
| 18 | Administrative, Miscellaneous and Investigational | $7 | <0.1% |
| 19 | Dental Services | $0 | <0.1% |
| 19 | Screening Procedures | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $2,019,364 | 12 |
| T1017 | Targeted case management | $1,119,101 | 12 |
| T2005 | N-et; stretcher van | $988,256 | 11 |
| T1005 | Respite care service 15 min | $349,028 | 12 |
| T2003 | N-et; encounter/trip | $347,903 | 12 |
| T2022 | Case management, per month | $227,799 | 11 |
| T2023 | Targeted case mgmt per month | $148,479 | 14 |
| T1027 | Family training & counseling | $112,005 | 21 |
| T1028 | Home environment assessment | $74,769 | 11 |
| T1023 | Program intake assessment | $52,959 | 11 |
| T1024 | Team evaluation & management | $49,955 | 11 |
| T1013 | Sign lang/oral interpreter | $17,241 | 43 |
| T1002 | Rn services up to 15 minutes | $4,769 | 9 |
| T2049 | N-et; stretcher van, mileage | $0 | 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.
