Portage Medicaid providers billed $1,835,170 for services categorized under National Codes Established for State Medicaid Agencies in 2024, as shown by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 207.2% rise compared with 2023, when similar claims totaled $597,410.
Medicaid, a joint state and federally funded health coverage program, provides insurance for low-income individuals and families, seniors, children, and people with disabilities. This makes it one of the largest components of U.S. health care, according to the Commonwealth Fund.
Because Medicaid is funded by taxpayers, trends in local billing levels help illustrate how public health care funds are used within a community.
The “National Codes Established for State Medicaid Agencies” category comprises a group of Medicaid-billed services designated by the nature of care provided, determined by standardized HCPCS and CPT coding sets. For this review, each billing code was aligned with a single service category using consistent prefixes and number ranges to group related services—ensuring no double-counting and enabling accurate longitudinal rankings.
Although growth was seen across multiple service categories, National Codes Established for State Medicaid Agencies was the second highest category in Portage in 2024 by total Medicaid payments.
Statewide in Wisconsin, National Codes Established for State Medicaid Agencies had the highest aggregate Medicaid payments in 2024.
Between 2019 and 2024, Portage Medicaid expenditures connected to this category rose by $1,524,461—a 490.6% increase. Some periods, such as in 2022 and 2023, saw especially rapid growth in annual spending for these services.
While payments for services in this category were distributed throughout Portage, the majority were concentrated in few ZIP codes. In 2024, ZIP code 53901 accounted for $1,835,169 of payments. The top ZIP code made up 100% of all Medicaid spending in this category in Portage that year.
Additionally, most Medicaid payments within the National Codes Established for State Medicaid Agencies category in Portage were tied to a small selection of individual billing codes.
When comparing changes from 2023 to 2024, payments in this category increased by 207.2% in Portage, in contrast to a 14.2% rise across all Medicaid service categories citywide during the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023, which made up about 18% of national health spending. That number represented an increase from roughly $613.5 billion in 2019, before the COVID-19 pandemic.
This jump amounts to nearly 40% growth in a few years, spurred mainly by expanded coverage and increased utilization linked to COVID-19 and its aftermath.
Recently enacted federal budget legislation signed during the Trump administration put forward significant reductions to federal Medicaid funding and changes to the structure of the program. Notably, the “One Big Beautiful Bill Act,” enacted in 2025, is projected to trim over $1 trillion from federal Medicaid funds over the next 10 years, introducing policies like work requirements and greater cost-sharing—measures expected to lower coverage and funding for certain beneficiaries. The result is likely to place a larger share of Medicaid costs on states and slow the growth of federal support, even as the program continues to serve tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $310,709 | 17.9% |
| 2021 | $333,611 | 7.4% |
| 2022 | $491,441 | 47.3% |
| 2023 | $597,410 | 21.6% |
| 2024 | $1,835,169 | 207.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $2,036,619 | 31.2% |
| 2 | National Codes Established for State Medicaid Agencies | $1,835,169 | 28.1% |
| 3 | Evaluation and Management | $1,287,290 | 19.7% |
| 4 | Medicine Services and Procedures | $751,154 | 11.5% |
| 5 | Pathology and Laboratory Procedures | $372,700 | 5.7% |
| 6 | Temporary National Codes (Non-Medicare) | $132,058 | 2% |
| 7 | Radiology Procedures | $79,369 | 1.2% |
| 8 | Procedures / Professional Services | $18,049 | 0.3% |
| 9 | Administrative, Miscellaneous and Investigational | $10,144 | 0.2% |
| 10 | Vision Services | $3,503 | 0.1% |
| 11 | Surgery | $1,543 | <0.1% |
| 12 | Temporary Codes | $539 | <0.1% |
| 13 | Drugs Administered Other than Oral Method | $48 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1016 | Case management | $455,705 | 20 |
| T2020 | Day habil waiver per diem | $411,833 | 8 |
| T2021 | Day habil waiver per 15 min | $216,776 | 8 |
| T2013 | Habil ed waiver per hour | $182,772 | 18 |
| T2015 | Habil prevoc waiver per hr | $141,976 | 8 |
| T2019 | Habil sup empl waiver 15min | $141,842 | 8 |
| T2014 | Habil prevoc waiver, per d | $140,037 | 8 |
| T1999 | Noc retail items andsupplies | $88,116 | 9 |
| T2003 | N-et; encounter/trip | $24,825 | 9 |
| T2025 | Waiver service, nos | $16,513 | 8 |
| T1017 | Targeted case management | $12,066 | 9 |
| T1003 | Lpn/lvn services up to 15min | $2,702 | 2 |
Note: HCPCS codes are provided for overview within the category. Category tallies and rankings in this article are based on standardized service groupings and not solely on individual billing codes.
All information for this article comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the source data here.
