In 2024, Medicaid providers in Nacogdoches billed $1,827,797 for services classified under the National Codes Established for State Medicaid Agencies, using data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 12% increase over 2023, when $1,632,669 was billed for these services.
Medicaid, a public health insurance initiative operated by the states and funded jointly by federal and state governments, provides coverage for low-income residents, seniors, children, and individuals with disabilities. It is one of the nation’s largest health care programs.
Since Medicaid funding comes from taxpayers, shifts in local billing reflect how health care resources are distributed across communities.
The “National Codes Established for State Medicaid Agencies” classification refers to a subset of Medicaid services defined by the care type, organized by HCPCS and CPT code groupings. For this report, billing codes were sorted into service categories by prefix and number range, allowing related care to be analyzed together while preventing duplication and accurately tracking trends over time.
Although Medicaid spending increased in several categories, National Codes Established for State Medicaid Agencies was the second largest by total Medicaid payments in Nacogdoches in 2024.
Statewide, Texas also ranked the National Codes Established for State Medicaid Agencies category second by total Medicaid payments in 2024.
During the five years ending in 2024, Medicaid payments in this category in Nacogdoches rose by $1,393,584, an increase of 320.9%. Notably, spending grew more rapidly in years such as 2021 and 2022.
Spending for the National Codes Established for State Medicaid Agencies was distributed throughout Nacogdoches, but most payments were concentrated in a small set of ZIP codes. In 2024, ZIP code 75961 accounted for $1,315,149, ZIP code 75965 for $474,694, and ZIP code 75964 for $37,952. Together, these top 3 ZIP codes represented 100% of the Medicaid payments linked to the category in Nacogdoches for the year.
Within this service category, a limited set of specific billing codes accounted for the majority of Medicaid payments.
For context, Medicaid payments for the National Codes Established for State Medicaid Agencies category in Nacogdoches climbed 12% from 2023 to 2024, while payments across all local Medicaid claim categories changed by 40% in the same period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid outlays totaled about $871.7 billion in fiscal year 2023, roughly 18% of total U.S. health expenditures, which was a substantial rise from $613.5 billion in 2019, before the COVID-19 pandemic.
This reflects a nearly 40% increase over a few years, with most of the growth linked to expanded enrollment and greater use of services during and after the pandemic.
Recent federal budget legislation during the Trump administration included major proposals to reduce Medicaid funding and revise its structure. The “One Big Beautiful Bill Act,” signed in 2025, is anticipated to cut more than $1 trillion in federal Medicaid spending over the coming decade and introduces policies such as mandatory work requirements and higher cost-sharing, potentially reducing coverage and funding for some recipients. These changes are expected to shift costs to states and limit the possible growth of federal Medicaid support, even as the program remains crucial for tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $434,212 | 8.8% |
| 2021 | $1,332,306 | 206.8% |
| 2022 | $1,481,647 | 11.2% |
| 2023 | $1,632,668 | 10.2% |
| 2024 | $1,827,796 | 12% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $3,212,747 | 32% |
| 2 | National Codes Established for State Medicaid Agencies | $1,827,796 | 18.2% |
| 3 | Enteral and Parenteral Therapy | $1,721,127 | 17.2% |
| 4 | Medicine Services and Procedures | $1,628,381 | 16.2% |
| 5 | Pathology and Laboratory Procedures | $511,376 | 5.1% |
| 6 | Dental Services | $478,345 | 4.8% |
| 7 | Surgery | $219,766 | 2.2% |
| 8 | Medical And Surgical Supplies | $175,089 | 1.7% |
| 9 | Radiology Procedures | $74,978 | 0.7% |
| 10 | Temporary National Codes (Non-Medicare) | $48,692 | 0.5% |
| 11 | Ambulance and Other Transport Services and Supplies | $38,489 | 0.4% |
| 12 | Durable Medical Equipment | $35,889 | 0.4% |
| 13 | Procedures / Professional Services | $31,202 | 0.3% |
| 14 | Vision Services | $13,247 | 0.1% |
| 15 | Anesthesia | $11,400 | 0.1% |
| 16 | Drugs Administered Other than Oral Method | $5,975 | 0.1% |
| 17 | Temporary Codes | $294 | <0.1% |
| 18 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $1,172,616 | 48 |
| T4534 | Youth size pull-on | $173,156 | 23 |
| T1019 | Personal care ser per 15 min | $172,676 | 12 |
| T4532 | Ped size pull-on lg | $60,118 | 12 |
| T4522 | Adult size brief/diaper med | $52,962 | 12 |
| T4526 | Adult size pull-on med | $41,640 | 12 |
| T2022 | Case management, per month | $37,952 | 11 |
| T4525 | Adult size pull-on sm | $36,223 | 12 |
| T4530 | Ped size brief/diaper lg | $34,931 | 12 |
| T4523 | Adult size brief/diaper lg | $20,295 | 11 |
| T4521 | Adult size brief/diaper sm | $17,701 | 11 |
| T2003 | N-et; encounter/trip | $3,279 | 1 |
| T1502 | Medication admin visit | $2,474 | 3 |
| T4527 | Adult size pull-on lg | $1,767 | 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.
