In 2024, Medicaid providers in Nogales reported $12,356,744 in billings for services included 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 shows. This amount reflected a 0.1% uptick from $12,341,001 in claims for the same category during 2023.
Medicaid, a public insurance program overseen by the states and funded by both federal and state governments, provides coverage for low-income people, families, seniors, children, and those with disabilities. It remains one of the largest segments of the U.S. health care sector.
Local shifts in Medicaid billing levels indicate where public dollars for health care are being spent in the community, since the program is tax-funded.
The “National Codes Established for State Medicaid Agencies” grouping represents services billed to Medicaid, defined by the specific care provided using standard HCPCS and CPT code sets. For this analysis, each code was matched to one service category according to consistent code prefixes and numeric ranges, helping align related services by type while avoiding double counting and supporting accurate ranking trends across years.
Medicaid payments for the National Codes Established for State Medicaid Agencies category accounted for the largest total among all service categories in Nogales in 2024.
Statewide, the National Codes Established for State Medicaid Agencies category also held the top spot for overall Medicaid payments in Arizona in 2024.
Over the five-year period before 2024, Nogales Medicaid payments in this category increased by $2,504,734, or 25.4%. Certain years, including 2021 and 2020, saw larger annual growth.
Although spending in this service category was spread throughout Nogales, the majority was concentrated in a few ZIP codes. In 2024, ZIP code 85621 recorded $12,356,744 in Medicaid payments in this category, accounting for 100% of Nogales’ total Medicaid spending for this group that year.
Most Medicaid payments within this category were associated with a small set of specific billing codes.
Between 2024 and 2023, Medicaid payments in this category in Nogales rose by 0.1%, while overall Medicaid claims across all categories in the city increased by 12.7% over the same period.
The Centers for Medicare & Medicaid Services reports that combined state and federal Medicaid spending reached about $871.7 billion during fiscal year 2023, making up roughly 18% of national health expenditures. This total marks a significant rise from $613.5 billion in 2019, just before the COVID-19 pandemic.
This growth amounts to an increase of about 40% over a few years, fueled largely by the expansion of enrollment and greater use of services linked to the pandemic and the period following it.
Recent federal budget legislation under the Trump administration has featured major proposals to decrease federal Medicaid contributions and change the structure of the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by over $1 trillion over the coming decade. It also advances policies such as work requirements and higher cost-sharing, which might lower coverage or funding for certain enrollees. These shifts are anticipated to increase states’ fiscal responsibility and restrict future federal growth, while Medicaid continues to cover millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $9,852,009 | 27.2% |
| 2021 | $13,913,883 | 41.2% |
| 2022 | $11,354,889 | -18.4% |
| 2023 | $12,341,001 | 8.7% |
| 2024 | $12,356,744 | 0.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $12,356,744 | 43.9% |
| 2 | Temporary National Codes (Non-Medicare) | $6,288,973 | 22.3% |
| 3 | Evaluation and Management | $5,618,647 | 2<0.1% |
| 4 | Radiology Procedures | $2,045,377 | 7.3% |
| 5 | Medicine Services and Procedures | $996,353 | 3.5% |
| 6 | Ambulance and Other Transport Services and Supplies | $526,365 | 1.9% |
| 7 | Alcohol and Drug Abuse Treatment | $173,302 | 0.6% |
| 8 | Drugs Administered Other than Oral Method | $96,467 | 0.3% |
| 9 | Pathology and Laboratory Procedures | $53,229 | 0.2% |
| 10 | Procedures / Professional Services | $6,253 | <0.1% |
| 11 | Surgery | $67 | <0.1% |
| 12 | Coronavirus Diagnostic Panel | $56 | <0.1% |
| 13 | Temporary Codes | $24 | <0.1% |
| 14 | Administrative, Miscellaneous and Investigational | $1 | <0.1% |
| 15 | Dental Services | $0 | <0.1% |
| 15 | Medical And Surgical Supplies | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $12,243,993 | 100 |
| T1016 | Case management | $100,870 | 23 |
| T1003 | Lpn/lvn services up to 15min | $11,535 | 12 |
| T1002 | Rn services up to 15 minutes | $344 | 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.
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.
