Medicaid payments for National Codes Established services in Keystone climb to $366,994 in 2024

In 2024, Medicaid providers in Keystone billed $366,994 for services falling under the National Codes Established for State Medicaid Agencies classification, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 36% increase over 2023, when claims totaled $269,840 for these services.

Medicaid operates as a public health insurance program managed by the states and receives joint financing from federal and state governments. It supports low-income residents, seniors, children and people with disabilities, making it a major component of the nation’s health care framework.

Because taxpayer funds finance Medicaid payments, fluctuations in local billing patterns reflect how health care resources are distributed within a community.

The “National Codes Established for State Medicaid Agencies” grouping encompasses a set of Medicaid-billed services categorized by care type, using standard HCPCS and CPT code clusters. For this study, each billing code was matched to a single service category based on consistent code prefixes and numerical spans, enabling related services to be analyzed together while avoiding duplication and supporting accurate rankings over time.

Medicaid spending increased across multiple categories, but National Codes Established for State Medicaid Agencies placed first in Keystone for total Medicaid payments in 2024.

Statewide in South Dakota, the National Codes Established for State Medicaid Agencies category also topped the list by total payments for 2024.

From 2019 through 2024, Keystone’s Medicaid payments associated with the National Codes Established for State Medicaid Agencies grouping rose by $206,910, a 129.3% increase. The pace of growth sped up in certain years, with clear year-over-year gains in 2021 and 2022.

Though these Medicaid expenditures covered services throughout the city, the highest payments occurred in a small number of ZIP codes. In 2024, ZIP code 57751 accounted for $366,994, representing 100% of all Medicaid payments in this category in Keystone for the year.

A small number of individual billing codes accounted for most Medicaid payments within the National Codes Established for State Medicaid Agencies category.

For context, the 36% increase in Medicaid payments tied to the National Codes Established for State Medicaid Agencies in Keystone between 2023 and 2024 was equivalent to the 36% change observed across all Medicaid claim categories in the city for the same period.

The Centers for Medicare & Medicaid Services report that federal and state Medicaid spending combined reached about $871.7 billion for fiscal year 2023, comprising nearly 18% of the nation’s total health expenditures—up significantly from approximately $613.5 billion in 2019, ahead of the COVID-19 pandemic.

This growth amounts to an increase of roughly 40% in just a few years, driven largely by expanded enrollment and greater health service utilization during and after the pandemic.

Recent federal budget actions during the Trump administration have included major proposals to shrink federal Medicaid funding and overhaul the program. The “One Big Beautiful Bill Act,” which became law in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next decade. It introduces work requirements and higher cost-sharing, which could decrease coverage and funding for certain beneficiaries. These policy shifts are expected to increase fiscal responsibility at the state level and constrain the rate of federal Medicaid funding growth, even as the program continues to cover 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.