Canton Medicaid payouts for National Codes Established for State Medicaid Agencies surge to $1,130,916 in 2024

Providers in Canton billed $1,130,916 to Medicaid for services categorized within the National Codes Established for State Medicaid Agencies in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This amount represents a 42.3% rise compared to 2023, when $794,940 in Medicaid claims were filed for these services.

Medicaid, the public health insurance program operated at the state level and financed through a federal-state partnership, provides coverage to low-income residents, seniors, children, and people living with disabilities. The program is a major component of the U.S. health care landscape.

Because Medicaid is taxpayer-funded, changes in local claims provide a window into how public health care resources are being distributed within the community.

The “National Codes Established for State Medicaid Agencies” service grouping comprises a defined set of Medicaid-provider services, organized according to standardized HCPCS and CPT code sets. To conduct this review, each individual billing code was mapped to one service category using uniform code prefixes and numeric criteria, aiding the analysis of similar services and supporting accurate rankings and comparison over time.

Medicaid outlays rose across several service categories, with National Codes Established for State Medicaid Agencies taking the top position for total Medicaid payments in Canton in 2024.

At the state level, the National Codes Established for State Medicaid Agencies category also led in total payments in Massachusetts in 2024.

From 2019 through 2024, Medicaid payments in Canton tied to this category rose by $330,068, an increase of 22.6%. Spending growth was higher in certain years, including notable year-over-year jumps in 2020 and 2021.

While funds for these services were allocated throughout Canton, the majority were concentrated in a small number of ZIP codes. In 2024, ZIP code 02021 accounted for $1,130,916 in Medicaid payments linked to this category. Combined, the leading ZIP code made up 100% of Canton’s payments for these services during the year.

Within this service category, Medicaid spending was also focused on a small subset of billing codes.

Between 2023 and 2024, Medicaid payments in Canton for this service group rose by 42.3%, in contrast to a 26% overall change seen in total Medicaid claims across all categories in the city over the same timeframe.

The Centers for Medicare & Medicaid Services reports that combined federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023. This was around 18% of all U.S. health spending—up from roughly $613.5 billion in 2019 prior to the COVID-19 pandemic.

This represents about 40% growth over several years, attributed broadly to expanded enrollment and higher utilization during and following the pandemic.

Recent major federal budget measures under the Trump administration have included significant plans to shrink federal Medicaid support and change the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is estimated to reduce federal Medicaid funding by more than $1 trillion in the decade ahead. The legislation brings new work requirements and higher cost-sharing, which could reduce funding and coverage for some groups. Such measures are expected to increase fiscal responsibility for states and curb growth in federal Medicaid contributions, even as the program continues to serve 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.