In 2024, Medicaid providers in Sierra Vista billed $8,121,491 under the National Codes Established for State Medicaid Agencies category, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 3.2% rise from 2023, when providers filed $7,868,125 in claims related to this service category.
Medicaid, a joint federal and state public health insurance program, is funded by both levels of government. It provides coverage for low-income individuals, families, seniors, children, and people with disabilities, making it a major component of the U.S. health care system.
Since Medicaid payments are taxpayer funded, trends in local billing help indicate how community health care resources are used.
The “National Codes Established for State Medicaid Agencies” category identifies a set of Medicaid services grouped by the type of care, determined by specific HCPCS and CPT codes. For this report, billing codes were consistently assigned to service categories using defined prefixes and numeric ranges, which allows similar services to be analyzed together and ensures no duplication in counts or rankings over time.
While Medicaid spending went up across several service types, National Codes Established for State Medicaid Agencies was the top category by total Medicaid payments in Sierra Vista in 2024.
Statewide in Arizona, National Codes Established for State Medicaid Agencies also had the highest total payments for 2024.
Between 2019 and 2024, Medicaid payments for the National Codes Established for State Medicaid Agencies group in Sierra Vista grew by $1,969,226, or 32%. Significant year-over-year increases occurred, particularly in 2020 and 2023.
Although these payments were spread throughout Sierra Vista, the majority were concentrated in a few ZIP codes. In 2024, ZIP code 85635 accounted for $8,121,490—representing 100% of Medicaid payments for this service group in the city that year.
Payments within the National Codes Established for State Medicaid Agencies category were also focused on a small number of specific billing codes.
To compare, Medicaid payments associated with the National Codes Established for State Medicaid Agencies group in Sierra Vista rose 3.2% from 2023 to 2024, while overall Medicaid claim categories saw a 7.3% change in the city over the same period.
According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid expenditures reached about $871.7 billion for fiscal year 2023, making up roughly 18% of the nation’s total health spending—a significant increase from around $613.5 billion in 2019, before the COVID-19 pandemic.
This rise represents about 40% growth over just a few years, with expanded enrollment and increased utilization during and after the pandemic as primary drivers.
Recent federal budget measures under the Trump administration have included major proposals to reduce federal Medicaid funding and change the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to cut federal Medicaid spending by more than $1 trillion over 10 years. It brings new requirements such as mandatory work provisions and increased cost-sharing, which may reduce coverage and funding for some recipients. As a result, states are likely to face increased financial responsibility and federal support may grow more slowly, even as Medicaid continues to cover millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $6,152,265 | 73.8% |
| 2021 | $6,487,169 | 5.4% |
| 2022 | $6,684,956 | 3% |
| 2023 | $7,868,124 | 17.7% |
| 2024 | $8,121,490 | 3.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $8,121,490 | 39.4% |
| 2 | Evaluation and Management | $3,517,115 | 17.1% |
| 3 | Ambulance and Other Transport Services and Supplies | $2,556,481 | 12.4% |
| 4 | Alcohol and Drug Abuse Treatment | $2,251,006 | 10.9% |
| 5 | Medicine Services and Procedures | $1,437,376 | 7% |
| 6 | Radiology Procedures | $1,009,254 | 4.9% |
| 7 | Drugs Administered Other than Oral Method | $524,711 | 2.5% |
| 8 | Pathology and Laboratory Procedures | $328,059 | 1.6% |
| 9 | Surgery | $277,170 | 1.3% |
| 10 | Temporary National Codes (Non-Medicare) | $218,685 | 1.1% |
| 11 | Durable Medical Equipment | $158,325 | 0.8% |
| 12 | Dental Services | $102,568 | 0.5% |
| 13 | Medical And Surgical Supplies | $58,563 | 0.3% |
| 14 | Anesthesia | $33,575 | 0.2% |
| 15 | Procedures / Professional Services | $13,220 | 0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $2,281 | <0.1% |
| 17 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $638 | <0.1% |
| 18 | Temporary Codes | $84 | <0.1% |
| 19 | Outpatient PPS | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $7,268,234 | 55 |
| T1016 | Case management | $796,760 | 64 |
| T1003 | Lpn/lvn services up to 15min | $47,701 | 12 |
| T1002 | Rn services up to 15 minutes | $4,580 | 4 |
| T4533 | Youth size brief/diaper | $2,115 | 3 |
| T4534 | Youth size pull-on | $2,097 | 2 |
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.
