Medicaid payments tied to national codes total $2,590,971 in Hallowell for 2024

Hallowell Medicaid providers submitted claims totaling $2,590,971 for services listed under the National Codes Established for State Medicaid Agencies in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflected a 4.7% increase over 2023, when providers filed $2,473,762 in claims within the same category.

Medicaid is a state-administered public health insurance program financed by both federal and state governments. It serves low-income residents, families, seniors, children, and those with disabilities, making it a significant segment of the nation’s health system.

Because taxpayer funds support Medicaid payments, fluctuations in local billing reveal how public dollars are allocated for community health care services.

The “National Codes Established for State Medicaid Agencies” category consists of Medicaid-billed services classified by type, based on defined HCPCS and CPT code groupings. Billing codes in this analysis were categorized by consistent prefixes and numeric ranges, making it possible to evaluate related services together and track precise rankings without redundancy over time.

Medicaid spending increased across multiple service groups, but National Codes Established for State Medicaid Agencies was the leading category by total Medicaid payments in Hallowell during 2024.

Across Maine, this category also topped the list for total Medicaid payments in 2024.

Over the five years up to 2024, Medicaid payments for this category in Hallowell rose by $1,217,462, or 88.6%. Growth in spending was more pronounced during certain timeframes, with significant annual increases in both 2021 and 2023.

Spending in the National Codes Established for State Medicaid Agencies category was spread citywide but remained concentrated in a limited number of ZIP codes. In 2024, ZIP code 04347 reported Medicaid payments totaling $2,590,970 tied to this category, representing 100% of Hallowell’s Medicaid spending for these services during the year.

Within this service category, a few specific billing codes accounted for most Medicaid payments.

Medicaid payments in Hallowell linked to the National Codes Established for State Medicaid Agencies category grew by 4.7% from 2023 to 2024, compared to a 4.9% overall increase across all Medicaid claim groups in the city for the same span.

The Centers for Medicare & Medicaid Services reports that combined state and federal Medicaid spending reached roughly $871.7 billion in fiscal year 2023. That figure makes up about 18% of the nation’s health expenditures and is a significant climb from approximately $613.5 billion in 2019, before COVID-19.

This jump signals about a 40% increase within a few years, largely attributable to increased enrollment and greater service use during and after the pandemic.

Recent federal budget laws during the Trump administration featured major proposals for reducing federal Medicaid allocations and restructuring the program. The “One Big Beautiful Bill Act,” approved in 2025, is estimated to slash more than $1 trillion in federal Medicaid funding over the next decade and introduces provisions such as work requirements and higher cost-sharing that may decrease coverage and funding for certain recipients. These adjustments are poised to shift more responsibility to states and are expected to restrict the pace of future federal Medicaid spending growth while the program continues to reach tens of millions of Americans.

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.