Durango Medicaid spending on state-established national codes grows to $4.3M in 2024

Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows Medicaid providers in Durango billed $4,268,464 for services under the National Codes Established for State Medicaid Agencies category in 2024. This amount reflects a 32.5% increase compared with the prior year, when billings for the same services reached $3,221,540.

Medicaid, administered by states and funded by both federal and state governments, provides health insurance to low-income individuals and families, seniors, children, and people with disabilities, making it a major component of the U.S. health care landscape.

Because Medicaid is funded through tax dollars, fluctuations in local billing are key indicators of how community health care resources are spent.

The “National Codes Established for State Medicaid Agencies” group refers to collections of Medicaid-billed services categorized by the type of care delivered, organized according to standardized HCPCS and CPT code groupings. For this report, each billing code was linked to a single service grouping using set code prefixes and numeric patterns, ensuring consistency, preventing duplication, and supporting accurate ranking comparisons over time.

While spending rose in various service groups, National Codes Established for State Medicaid Agencies led all categories by total Medicaid payments in Durango for 2024.

This service category also held the top statewide ranking for total Medicaid payments in Colorado during 2024.

Reviewing a five-year span through 2024, Medicaid payments stemming from the National Codes Established for State Medicaid Agencies grouping in Durango grew by $693,790, equating to 19.4%. Notable year-over-year gains occurred in 2022 and 2022 as growth accelerated during selected periods.

Across Durango, funds spent for services in this category were distributed citywide, but were concentrated in just a few ZIP codes. In 2024, ZIP code 81303 accounted for $4,263,387 and 81301 for $5,077, with the combined total making up 100% of Medicaid billings in this service category for the city that year.

Medicaid payments in this grouping were also concentrated among a small cluster of individual billing codes.

Between 2024 and 2023, Medicaid payments connected to the National Codes Established for State Medicaid Agencies group in Durango jumped 32.5%, versus a 20.8% shift across all Medicaid claim types citywide during that period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid outlays reached approximately $871.7 billion for fiscal 2023, representing about 18% of all U.S. health expenditures. That marks a considerable rise from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This roughly 40% increase over several years has largely been attributed to expanded enrollment and greater service use during and after the pandemic.

Federal budget legislation passed under the Trump administration brought forward proposed major reductions in federal Medicaid contributions and reconfiguration of the program itself. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to lower federal Medicaid spending by more than $1 trillion over 10 years and introduce measures like work requirements and raised cost-sharing that could restrict benefits and funds for select recipients. These changes are likely to place more financial responsibility on states and curb the rate of federal Medicaid support, even as the program continues to reach tens of millions of Americans.

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.