In 2024, Cortez Medicaid providers billed $2,068,272 for services falling 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 amount represents a 26% increase from 2023, when claims for that same service totaled $1,641,351.
Medicaid, a joint federal and state government health insurance program, serves low-income individuals, families, seniors, children and people with disabilities, making it one of the largest segments of the U.S. health care system. More details can be found at the Commonwealth Fund.
As Medicaid is funded by taxpayers, variations in local billing can reveal how public health care resources are distributed within a particular community.
The “National Codes Established for State Medicaid Agencies” group encompasses Medicaid-billed services defined by the care delivered, according to standardized HCPCS and CPT code sets. For this analysis, each billing code was placed in a single service category based on uniform code ranges, ensuring like services are analyzed together and double counting is avoided, while maintaining accuracy in category rankings over time.
Despite increases in Medicaid spending across several categories, National Codes Established for State Medicaid Agencies was the third highest by total Medicaid payments in Cortez in 2024.
Statewide in Colorado, this category led all others in Medicaid payments in 2024.
Between 2019 and 2024, Medicaid payments for the National Codes Established for State Medicaid Agencies category in Cortez rose by $953,756, an 85.6% gain. There were periods of more rapid growth, including significant jumps in both 2023 and 2020.
While these Medicaid payments spanned Cortez, they were mostly concentrated within a few ZIP codes. In 2024, ZIP code 81321 saw the entire $2,068,272 in Medicaid payments tied to this category. The single top ZIP code accounted for 100% of these payments in the city for the year.
Payments within the National Codes Established for State Medicaid Agencies group were also concentrated among a relatively small number of billing codes.
Comparatively, Cortez Medicaid payments for this category jumped 26% from 2023 to 2024, while payments across all Medicaid claim types in the city grew by 9.5% during the same period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending together reached about $871.7 billion in fiscal 2023, making up around 18% of total national health expenditures. That figure increased sharply from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.
This reflects approximate growth of 40% over several years, attributed primarily to expanded program enrollment and heightened use of services during and after the pandemic.
Federal budget legislation under the Trump administration recently included major Medicaid funding reductions and restructuring. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to cut more than $1 trillion in federal Medicaid spending in the next decade, introducing work requirements and higher cost-sharing that could reduce both coverage and federal funds for some recipients. These changes are anticipated to place greater financial responsibility on states and restrict future federal Medicaid growth, even as the program continues to cover tens of millions nationally.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,114,515 | 25.9% |
| 2021 | $935,360 | -16.1% |
| 2022 | $1,023,645 | 9.4% |
| 2023 | $1,641,351 | 60.3% |
| 2024 | $2,068,272 | 26% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $3,748,195 | 34.4% |
| 2 | Alcohol and Drug Abuse Treatment | $2,097,438 | 19.2% |
| 3 | National Codes Established for State Medicaid Agencies | $2,068,272 | 19% |
| 4 | Temporary National Codes (Non-Medicare) | $1,058,225 | 9.7% |
| 5 | Medicine Services and Procedures | $938,799 | 8.6% |
| 6 | Durable Medical Equipment | $398,527 | 3.7% |
| 7 | Ambulance and Other Transport Services and Supplies | $291,022 | 2.7% |
| 8 | Dental Services | $140,087 | 1.3% |
| 9 | Pathology and Laboratory Procedures | $57,204 | 0.5% |
| 10 | Vision Services | $54,617 | 0.5% |
| 11 | Medical And Surgical Supplies | $37,626 | 0.3% |
| 12 | Procedures / Professional Services | $4,721 | <0.1% |
| 13 | Outpatient PPS | $3,358 | <0.1% |
| 14 | Radiology Procedures | $3,100 | <0.1% |
| 15 | Surgery | $1,192 | <0.1% |
| 16 | Temporary Codes | $278 | <0.1% |
| 17 | Drugs Administered Other than Oral Method | $206 | <0.1% |
| 18 | Administrative, Miscellaneous and Investigational | $44 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $1,525,937 | 35 |
| T2021 | Day habil waiver per 15 min | $230,890 | 5 |
| T2016 | Habil res waiver per diem | $221,393 | 1 |
| T2031 | Assist living waiver/diem | $89,043 | 3 |
| T1017 | Targeted case management | $1,007 | 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.
