In 2024, Medicaid providers in Newark submitted $125,579,808 in claims for services under the National Codes Established for State Medicaid Agencies, based on the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 4% increase from 2023, when $120,798,161 was billed for the same services.
Medicaid is a state-run public health insurance program funded jointly by state and federal governments. It provides coverage for people with low incomes, seniors, children, and individuals with disabilities, making it a significant component of the U.S. health care system.
Since Medicaid uses taxpayer funding, shifts in local billing reflect how public health resources are allocated in the area.
The “National Codes Established for State Medicaid Agencies” category includes a group of Medicaid-billed services identified by type of care, using standardized groupings from HCPCS and CPT codes. For this report, each code was assigned to a single service group through consistent code prefixes and numerical ranges to group related services, avoid double counting, and accurately track rankings over time.
Medicaid spending grew across several service types, with National Codes Established for State Medicaid Agencies ranking as the top category in Newark for total Medicaid payments in 2024.
Statewide, the National Codes Established for State Medicaid Agencies category was also the leading category by total Medicaid payments in Delaware in 2024.
Comparing the five years through 2024, Medicaid payments for the National Codes Established for State Medicaid Agencies category in Newark rose by $70,744,466, or 129%. Spending increases were particularly notable in 2022 and 2021.
Payments for care in this category were distributed citywide but were concentrated in several ZIP codes. In 2024, the highest Medicaid payments linked to the National Codes Established for State Medicaid Agencies were in ZIP code 19702, with $71,706,387; ZIP code 19711, at $48,872,297; and ZIP code 19713, with $4,993,319. Collectively, these 3 ZIP codes made up 100% of the Medicaid payments tied to the category in Newark.
Within the National Codes Established for State Medicaid Agencies category, most Medicaid payments were focused on a few individual billing codes.
Between 2024 and 2023, Medicaid payments in this category in Newark increased by 4%, compared to an 8.3% change for all Medicaid claim types in the city during the same time frame.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures totaled about $871.7 billion in fiscal year 2023, which was around 18% of all U.S. health spending—a sharp increase from roughly $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This change reflects a growth of about 40% in just a few years, driven in large part by broader enrollment and greater utilization during and after the pandemic.
Recent federal budget initiatives during the Trump administration included notable proposals to decrease federal Medicaid funding and alter the program’s structure. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to cut over $1 trillion in federal Medicaid spending over the next decade. It introduces requirements such as work mandates and more cost-sharing, potentially reducing coverage and funding for certain beneficiaries. As a result, states are anticipated to take on greater funding responsibilities and face constraints on federal Medicaid funding growth, even as the program continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $54,835,341 | 7.4% |
| 2021 | $75,667,288 | 38% |
| 2022 | $107,528,794 | 42.1% |
| 2023 | $120,798,160 | 12.3% |
| 2024 | $125,579,807 | 4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $125,579,807 | 77.2% |
| 2 | Evaluation and Management | $13,483,263 | 8.3% |
| 3 | Temporary National Codes (Non-Medicare) | $10,208,688 | 6.3% |
| 4 | Procedures / Professional Services | $2,766,372 | 1.7% |
| 5 | Medicine Services and Procedures | $2,222,909 | 1.4% |
| 6 | Drugs Administered Other than Oral Method | $2,098,377 | 1.3% |
| 7 | Radiology Procedures | $1,584,178 | 1% |
| 8 | Dental Services | $1,376,472 | 0.8% |
| 9 | Surgery | $1,188,539 | 0.7% |
| 10 | Alcohol and Drug Abuse Treatment | $845,282 | 0.5% |
| 11 | Pathology and Laboratory Procedures | $420,324 | 0.3% |
| 12 | Chemotherapy Drugs | $337,631 | 0.2% |
| 13 | Ambulance and Other Transport Services and Supplies | $164,076 | 0.1% |
| 14 | Medical And Surgical Supplies | $124,569 | 0.1% |
| 15 | Durable Medical Equipment | $85,480 | 0.1% |
| 16 | Enteral and Parenteral Therapy | $38,639 | <0.1% |
| 17 | Anesthesia | $36,738 | <0.1% |
| 18 | Administrative, Miscellaneous and Investigational | $14,292 | <0.1% |
| 19 | Temporary Codes | $8,029 | <0.1% |
| 20 | Coronavirus Diagnostic Panel | $1,774 | <0.1% |
| 21 | Vision Services | $166 | <0.1% |
| 22 | Orthotic Procedures and services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2025 | Waiver service, nos | $80,249,783 | 58 |
| T2016 | Habil res waiver per diem | $33,252,635 | 42 |
| T2020 | Day habil waiver per diem | $4,285,457 | 12 |
| T2023 | Targeted case mgmt per month | $3,327,887 | 11 |
| T2019 | Habil sup empl waiver 15min | $2,501,735 | 23 |
| T2021 | Day habil waiver per 15 min | $1,234,422 | 34 |
| T1001 | Nursing assessment/evaluatn | $431,253 | 42 |
| T2004 | N-et; commerc carrier pass | $296,632 | 23 |
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.
