In 2024, Medicaid providers in North Miami Beach billed $4,618,730 for services categorized under the National Codes Established for State Medicaid Agencies, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represented a 28.3% rise over 2023, when $3,600,046 was billed for the same services.
Medicaid is a public health insurance program administered by the states and funded by both federal and state governments. The program covers low-income individuals and families, seniors, children, and people with disabilities, making it one of the largest segments of the U.S. health care system.
Since Medicaid funding comes from taxpayers, changes in local billing levels illustrate how public health care spending is distributed in a community.
The “National Codes Established for State Medicaid Agencies” category represents Medicaid-billed services defined by the specific care provided, classified using standardized HCPCS and CPT code groupings. For this report, each billing code was placed in a single service category based on code prefixes and number ranges, ensuring related services could be grouped while avoiding duplicate counts and maintaining accurate historical rankings.
Medicaid spending increased across various service groups, but National Codes Established for State Medicaid Agencies ranked as the top Medicaid payment category in North Miami Beach in 2024.
Across Florida, this service category held the second-highest total Medicaid payment ranking for 2024.
Throughout the five years leading up to 2024, North Miami Beach’s Medicaid payments for the National Codes Established for State Medicaid Agencies category grew by $3,895,520, amounting to an increase of 538.6%. Periods of accelerated growth were observed, particularly in 2022 and 2023.
Although services in this category were offered citywide, Medicaid payments were mostly concentrated in several ZIP codes. The largest amounts in 2024 were attributed to ZIP code 33162, with $3,172,590; 33169, at $763,270; and 33179, at $678,946. Combined, these top 3 ZIP codes accounted for 99.9% of all Medicaid payments for this category in North Miami Beach for the year.
Medicaid payments within this service group were also focused among a small number of individual billing codes.
By comparison, Medicaid payments for the National Codes Established for State Medicaid Agencies category in North Miami Beach increased by 28.3% from 2023 to 2024, while all Medicaid claim categories in the city grew by 11.1% during the same time period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending totaled about $871.7 billion in fiscal year 2023, which made up nearly 18% of all national health expenditures, a significant jump from approximately $613.5 billion in 2019, prior to the COVID-19 pandemic.
This marks an increase of roughly 40% in just a few years, largely due to expanded enrollment and increased usage during and after the pandemic.
Recent federal budget legislation under the Trump administration introduced significant proposals to reduce federal Medicaid funding and change the program’s structure. The “One Big Beautiful Bill Act,” signed in 2025, is expected to lower federal Medicaid spending by more than $1 trillion over a decade and implement policies such as work requirements and greater cost-sharing, which could reduce coverage and funding for some beneficiaries. These measures are anticipated to shift additional costs to states and slow federal Medicaid spending growth, even as the program continues to serve tens of millions across the nation.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $723,209 | 24% |
| 2021 | $1,024,635 | 41.7% |
| 2022 | $2,163,503 | 111.1% |
| 2023 | $3,600,045 | 66.4% |
| 2024 | $4,618,729 | 28.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $4,618,729 | 28.4% |
| 2 | Temporary National Codes (Non-Medicare) | $3,347,434 | 20.6% |
| 3 | Evaluation and Management | $3,264,599 | 20.1% |
| 4 | Medicine Services and Procedures | $2,366,751 | 14.6% |
| 5 | Alcohol and Drug Abuse Treatment | $1,921,515 | 11.8% |
| 6 | Radiology Procedures | $333,864 | 2.1% |
| 7 | Medical And Surgical Supplies | $148,585 | 0.9% |
| 8 | Durable Medical Equipment | $84,501 | 0.5% |
| 9 | Surgery | $84,214 | 0.5% |
| 10 | Dental Services | $37,804 | 0.2% |
| 11 | Procedures / Professional Services | $15,961 | 0.1% |
| 12 | Pathology and Laboratory Procedures | $13,070 | 0.1% |
| 13 | Anesthesia | $5,989 | <0.1% |
| 14 | Drugs Administered Other than Oral Method | $1,609 | <0.1% |
| 15 | Chemotherapy Drugs | $844 | <0.1% |
| 16 | Other Services | $0 | <0.1% |
| 16 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $1,832,607 | 24 |
| T1025 | Ped compr care pkg, per diem | $1,104,787 | 12 |
| T2030 | Assist living waiver/month | $763,123 | 12 |
| T1004 | Nsg aide service up to 15min | $436,228 | 12 |
| T1017 | Targeted case management | $267,997 | 16 |
| T1021 | Hh aide or cn aide per visit | $174,943 | 8 |
| T1015 | Clinic service | $26,682 | 18 |
| T1030 | Rn home care per diem | $12,127 | 11 |
| T1007 | Treatment plan development | $146 | 1 |
| T2002 | N-et; per diem | $85 | 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.
