West Chester Medicaid payments for National Codes Established for State Medicaid Agencies total $3.7 million in 2024

In 2024, providers in West Chester billed $3,678,758 to Medicaid for services under the National Codes Established for State Medicaid Agencies category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This represents a 585.1% jump from 2023, when claims for the same service category totaled $536,943.

Medicaid operates as a state-administered public insurance program funded by both federal and state governments. Covering low-income families and individuals, seniors, children, and people with disabilities, it comprises a significant component of the national health care system.

Because taxpayer contributions fund Medicaid, fluctuations in community billing levels reflect how public health care funding is directed locally.

The “National Codes Established for State Medicaid Agencies” grouping encompasses Medicaid services classified by type of care, following organized HCPCS and CPT code sets. For this review, each billing code was placed into a singular service category based on established code prefixes and numbering, allowing grouping of related services, minimizing overlap, and maintaining reliable rankings over time.

Medicaid expenditures grew in multiple service areas in West Chester, with National Codes Established for State Medicaid Agencies ranking second by total Medicaid payments in 2024.

Across Pennsylvania, National Codes Established for State Medicaid Agencies also ranked second by statewide total payments in 2024.

From 2019 to 2024, West Chester’s Medicaid payments connected to National Codes Established for State Medicaid Agencies increased by $1,734,071, or 89.2%. These increases intensified at points, particularly in 2020 and 2021.

Even though several city ZIP codes saw Medicaid spending in this category, the majority of payments originated from a few. In 2024, ZIP code 19382 recorded $3,169,262 and 19380 recorded $509,494. Combined, these top 2 ZIP codes made up 100% of local Medicaid payments in this category for the year.

A small set of billing codes accounted for most Medicaid spending within National Codes Established for State Medicaid Agencies in West Chester.

Medicaid payments for this category climbed 585.1% from 2023 to 2024 in West Chester, compared with a 7% overall increase across all Medicaid spending categories in the city for the same time period.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending together totaled approximately $871.7 billion in fiscal year 2023, or roughly 18% of total U.S. health expenditures, up sharply from about $613.5 billion in 2019 before the COVID-19 pandemic.

This signifies about 40% growth in only a few years, largely due to higher enrollment and greater service use during and following the pandemic.

Federal budget measures under the Trump administration have included major plans to trim Medicaid funding and modify the program’s structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is set to cut over $1 trillion in federal Medicaid spending over the next decade. It also introduces work requirements and higher cost-sharing, potentially reducing coverage and federal support for some beneficiaries. These adjustments may shift more responsibility to the states, limiting federal Medicaid funding growth as the program continues to cover millions.

Note: HCPCS codes are provided for category context. The totals and rankings noted in this article are based on service groupings instead of individual codes.

Data in this article comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source is available here.