Mechanicsburg Medicaid providers reported $4,119,617 in billed services under the National Codes Established for State Medicaid Agencies category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. The figure represents a 20.9% jump from 2023, when claims for the same services totaled $3,406,650.
Medicaid, a public health insurance program managed by states and financed jointly by federal and state governments, serves low-income individuals and families, seniors, children, and people with disabilities, forming a major component of the U.S. health system.
Because taxpayer funds support Medicaid, fluctuations in local billings reveal shifts in how public health care funds are spent within individual communities.
The National Codes Established for State Medicaid Agencies category comprises a set of Medicaid services designated by care type, relying on standardized HCPCS and CPT code groupings. For this report, each billing code was placed within a single service category using consistent code prefixes and numeric ranges. This method allows for analysis of related services without double counting, maintaining accuracy in rankings over time.
Although Medicaid spending rose in several service categories, in Mechanicsburg the National Codes Established for State Medicaid Agencies led all categories in total Medicaid payments for 2024.
Statewide in Pennsylvania, this category ranked second in total Medicaid payments during 2024.
Over the five years preceding 2024, Medicaid payments linked to the National Codes Established for State Medicaid Agencies category in Mechanicsburg increased by $4,110,749, which is a rise of 46355.9%. During this time, notable year-over-year increases were seen in 2023 and 2021.
While these Medicaid payments were distributed across Mechanicsburg, the majority were concentrated in just a few ZIP codes. In 2024, ZIP code 17055 accounted for $3,610,337 and 17050 accounted for $509,279. Combined, these top 2 ZIP codes represented 100% of Medicaid spending tied to this category in the city for the year.
A small group of individual billing codes made up the bulk of Medicaid payments within this category.
Comparatively, Medicaid payments tied to the National Codes Established for State Medicaid Agencies in Mechanicsburg rose by 20.9% from 2023 to 2024, surpassing the 11.6% increase recorded across all Medicaid claim categories during the same period.
The Centers for Medicare & Medicaid Services reports total federal and state Medicaid spending reached nearly $871.7 billion in fiscal 2023, making up about 18% of overall U.S. health expenditures. This was a notable jump from $613.5 billion in 2019, before the COVID-19 pandemic.
This surge translates to roughly 40% growth over a few years, largely attributed to increased enrollment and greater service use during and after the pandemic.
Recent federal budget changes during the Trump administration have introduced policies to reduce federal Medicaid support and restructure funding. The “One Big Beautiful Bill Act,” enacted in 2025, is set to reduce over $1 trillion in federal Medicaid spending over 10 years, introducing measures such as work requirements and greater cost-sharing, which may reduce coverage or funds for some. As a result, states may bear more costs and see limits on federal Medicaid funding, even as the program continues to serve tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $8,867 | 174.7% |
| 2021 | $62,622 | 606.2% |
| 2022 | $117,444 | 87.5% |
| 2023 | $3,406,650 | 2800.6% |
| 2024 | $4,119,616 | 20.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $4,119,616 | 35% |
| 2 | Medicine Services and Procedures | $2,020,506 | 17.2% |
| 3 | Alcohol and Drug Abuse Treatment | $1,763,973 | 15% |
| 4 | Procedures / Professional Services | $1,259,724 | 10.7% |
| 5 | Temporary National Codes (Non-Medicare) | $948,230 | 8.1% |
| 6 | Evaluation and Management | $684,491 | 5.8% |
| 7 | Durable Medical Equipment | $398,523 | 3.4% |
| 8 | Medical And Surgical Supplies | $197,237 | 1.7% |
| 9 | Ambulance and Other Transport Services and Supplies | $182,175 | 1.5% |
| 10 | Vision Services | $126,052 | 1.1% |
| 11 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $23,933 | 0.2% |
| 12 | Orthotic Procedures and services | $17,871 | 0.2% |
| 13 | Pathology and Laboratory Procedures | $9,808 | 0.1% |
| 14 | Dental Services | $9,029 | 0.1% |
| 15 | Surgery | $1,056 | <0.1% |
| 16 | Radiology Procedures | $842 | <0.1% |
| 17 | Drugs Administered Other than Oral Method | $1 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1003 | Lpn/lvn services up to 15min | $2,787,502 | 11 |
| T1002 | Rn services up to 15 minutes | $700,429 | 9 |
| T1015 | Clinic service | $509,279 | 56 |
| T4534 | Youth size pull-on | $44,515 | 12 |
| T4526 | Adult size pull-on med | $21,793 | 11 |
| T1016 | Case management | $19,873 | 5 |
| T4527 | Adult size pull-on lg | $12,513 | 8 |
| T4541 | Large disposable underpad | $7,469 | 12 |
| T4540 | Reusable underpad chair size | $7,381 | 10 |
| T4535 | Disposable liner/shield/pad | $3,612 | 5 |
| T4530 | Ped size brief/diaper lg | $2,887 | 2 |
| T4532 | Ped size pull-on lg | $1,323 | 1 |
| T4525 | Adult size pull-on sm | $1,035 | 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.
The data for this article originates from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original dataset is available here.
