In 2024, Danville medical providers billed $5,534,185 for services under the National Codes Established for State Medicaid Agencies category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure reflects a 1.8% increase over 2023, when claims totaling $5,438,478 were recorded in this category.
Medicaid, operated at the state level and financed by both federal and state governments, provides health insurance to low-income people, seniors, children, and individuals with disabilities, making it one of the largest components of the nation’s health care system.
Because Medicaid funding comes from taxpayer sources, shifts in local billing reveal how health care dollars are distributed within the community.
The “National Codes Established for State Medicaid Agencies” group includes Medicaid-billed services defined by the type of care, organized by standard HCPCS and CPT code sets. For this analysis, billing codes were grouped into a single service category based on code prefixes and ranges to compare related services accurately and avoid double counting.
Among all service categories seeing higher Medicaid spending, National Codes Established for State Medicaid Agencies was ranked as the leading category in Danville by total Medicaid payments in 2024.
Statewide, the National Codes Established for State Medicaid Agencies category also led in total Medicaid payments in Illinois in 2024.
Throughout the five years ending in 2024, Medicaid payments in Danville for this category grew by $1,077,599, marking a 24.2% rise. Certain years, such as 2022 and 2023, recorded pronounced year-over-year growth in spending.
Though these Medicaid expenditures were dispersed throughout Danville, the majority came from just a few ZIP codes. In 2024, the largest shares were from ZIP code 61832, which totaled $5,501,863, and ZIP code 61834 at $32,321. These 2 ZIP codes made up 100% of the city’s Medicaid spending in this category for the year.
Within this category, a limited selection of billing codes accounted for the bulk of Medicaid payments.
For context, Medicaid spending on these state-established codes in Danville climbed 1.8% from 2023 to 2024, compared to a 6.9% increase seen across all service categories in Danville in the same span.
According to the Centers for Medicare & Medicaid Services, national federal and state Medicaid spending reached approximately $871.7 billion in the 2023 fiscal year, accounting for about 18% of total U.S. health expenditures, significantly higher than the $613.5 billion reported in 2019, before the COVID-19 pandemic.
This jump reflects roughly 40% growth in just a few years, largely tied to greater enrollment and rising use of services during and after the pandemic.
Recent federal budget actions enacted under the Trump administration have included major proposals to lower federal Medicaid funding and alter the structure of the program. Notably, the “One Big Beautiful Bill Act,” passed in 2025, is expected to cut over $1 trillion from federal Medicaid spending in the next decade, introducing measures such as work requirements and increased cost-sharing that could restrict coverage and funding for certain participants. These changes are anticipated to shift more costs to states and slow federal Medicaid support growth, even as the program continues to provide care for tens of millions of residents.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $4,456,585 | -29.6% |
| 2021 | $4,476,808 | 0.5% |
| 2022 | $5,335,183 | 19.2% |
| 2023 | $5,438,478 | 1.9% |
| 2024 | $5,534,184 | 1.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $5,534,184 | 79.4% |
| 2 | Alcohol and Drug Abuse Treatment | $678,964 | 9.7% |
| 3 | Medicine Services and Procedures | $282,430 | 4.1% |
| 4 | Temporary National Codes (Non-Medicare) | $261,084 | 3.7% |
| 5 | Durable Medical Equipment | $124,872 | 1.8% |
| 6 | Medical And Surgical Supplies | $70,156 | 1% |
| 7 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $11,685 | 0.2% |
| 8 | Pathology and Laboratory Procedures | $2,613 | <0.1% |
| 9 | Evaluation and Management | $1,950 | <0.1% |
| 10 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| 11 | Procedures / Professional Services | $0 | <0.1% |
| 12 | Surgery | $0 | <0.1% |
| 12 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $5,322,953 | 58 |
| T1040 | Comm bh clinic svc per diem | $81,411 | 12 |
| T1016 | Case management | $57,694 | 12 |
| T1021 | Hh aide or cn aide per visit | $32,321 | 4 |
| T4541 | Large disposable underpad | $17,659 | 11 |
| T4526 | Adult size pull-on med | $11,319 | 6 |
| T4535 | Disposable liner/shield/pad | $3,613 | 7 |
| T1502 | Medication admin visit | $2,422 | 3 |
| T4527 | Adult size pull-on lg | $1,705 | 1 |
| T4528 | Adult size pull-on xl | $1,583 | 1 |
| T4525 | Adult size pull-on sm | $1,501 | 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.
