Sterling Medicaid providers submitted $3,752,400 in claims for services within the National Codes Established for State Medicaid Agencies category in 2024, U.S. Department of Health and Human Services Medicaid Provider Spending data show. That amount was 17.8% higher than in 2023, when providers billed $3,185,150 for the same classification.
Medicaid is a publicly funded health insurance program administered by states and jointly financed by state and federal governments. It serves low-income populations, including families, older adults, children, and individuals with disabilities, and is a major segment of the health care system in the United States.
Fluctuations in local Medicaid billing reflect how taxpayer-funded public health care dollars are distributed within communities.
The “National Codes Established for State Medicaid Agencies” group incorporates Medicaid services defined according to HCPCS and CPT coding structures. For this reporting, billing codes were placed in a single service category based on their prefixes and number ranges for more accurate group comparisons and cleaner year-to-year trend analysis.
Of all Medicaid service groupings in Sterling, National Codes Established for State Medicaid Agencies saw the highest aggregate payments in 2024.
At the state level, this category also led as the top recipient of Medicaid dollars in Colorado in 2024.
From five years prior to 2024, Medicaid payments for this category in Sterling rose by $722,547, representing 23.8% growth. Accelerated increases were recorded in select periods, specifically in 2023 and 2022.
Although services within National Codes Established for State Medicaid Agencies were provided across Sterling, Medicaid payments were predominantly linked to a few ZIP codes. In 2024, ZIP code 80751 saw $3,752,400 in payments, with this single code representing all Medicaid claims under the category for the city that year.
Payments in this category were also concentrated in just a handful of billing codes.
Comparing 2024 to 2023, Sterling’s Medicaid billings for National Codes Established for State Medicaid Agencies rose 17.8%. Across all Medicaid claim categories during the same period, the increase citywide was 11.3%.
According to data from the Centers for Medicare & Medicaid Services, combined federal and state spending for Medicaid amounted to approximately $871.7 billion in fiscal 2023. This accounted for nearly 18% of total national health expenditure and reflected a steep rise from roughly $613.5 billion in 2019, before the COVID-19 pandemic.
This change signals about 40% growth in only a few years, with expansion mainly due to increased enrollment and greater health care usage during and following the pandemic.
Recent federal budgets under the Trump administration introduced significant changes aimed at reducing federal spending on Medicaid and overhauling program structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid expenditures by over $1 trillion over 10 years. The law includes measures such as work requirements and greater cost-sharing, which could mean less coverage and funding for certain eligible groups. These amendments are projected to increase state responsibility for Medicaid costs, while slowing federal support, even as the program continues to cover tens of millions of people.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $3,029,853 | -21.9% |
| 2021 | $2,313,168 | -23.7% |
| 2022 | $2,560,301 | 10.7% |
| 2023 | $3,185,150 | 24.4% |
| 2024 | $3,752,400 | 17.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $3,752,400 | 58.7% |
| 2 | Evaluation and Management | $915,058 | 14.3% |
| 3 | Temporary National Codes (Non-Medicare) | $621,088 | 9.7% |
| 4 | Dental Services | $263,311 | 4.1% |
| 5 | Medicine Services and Procedures | $245,331 | 3.8% |
| 6 | Durable Medical Equipment | $212,043 | 3.3% |
| 7 | Alcohol and Drug Abuse Treatment | $140,875 | 2.2% |
| 8 | Temporary Codes | $139,037 | 2.2% |
| 9 | Ambulance and Other Transport Services and Supplies | $91,314 | 1.4% |
| 10 | Medical And Surgical Supplies | $8,210 | 0.1% |
| 11 | Pathology and Laboratory Procedures | $3,133 | <0.1% |
| 12 | Radiology Procedures | $2,062 | <0.1% |
| 13 | Procedures / Professional Services | $989 | <0.1% |
| 14 | Drugs Administered Other than Oral Method | $241 | <0.1% |
| 15 | Surgery | $87 | <0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $1,359,744 | 11 |
| T2021 | Day habil waiver per 15 min | $946,613 | 32 |
| T1019 | Personal care ser per 15 min | $559,468 | 11 |
| T2031 | Assist living waiver/diem | $413,218 | 12 |
| T2003 | N-et; encounter/trip | $388,383 | 33 |
| T1017 | Targeted case management | $83,115 | 22 |
| T2028 | Special supply, nos waiver | $1,740 | 2 |
| T1016 | Case management | $116 | 1 |
Note: HCPCS codes are provided to illustrate context for this category. Article totals and category rankings are determined based on harmonized service group assignments rather than by direct count of billing codes.
Details in this article originate from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Source data can be accessed here.
