Wheat Ridge Medicaid providers billed $25,749,689 in 2024 for services within the National Codes Established for State Medicaid Agencies group, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 46.3% rise from 2023, when claims for the same type totaled $17,597,859.
Medicaid, a public health insurance program administered by states and funded jointly by federal and state governments, provides coverage for low-income individuals, families, seniors, children, and people with disabilities, and remains a major component of the U.S. health care system.
Changes in local Medicaid billing reflect shifts in how government-funded health care dollars are distributed in a given community, since these payments come from taxpayers.
The “National Codes Established for State Medicaid Agencies” category includes a set of Medicaid-billed services identified by care type, using standardized HCPCS and CPT code groupings. In the analysis, each code was mapped to a unique service category according to consistent prefixes and number ranges, ensuring related services were grouped together and double counting was avoided while maintaining accurate rankings over time.
National Codes Established for State Medicaid Agencies accounted for the largest share of total Medicaid payments in Wheat Ridge in 2024, outpacing other service categories.
Across Colorado, the National Codes Established for State Medicaid Agencies service group also ranked first by total Medicaid payments in 2024.
Medicaid payments for the National Codes Established for State Medicaid Agencies category in Wheat Ridge grew by $13,437,085, or 109.1%, over the five-year period ending in 2024. Growth rates accelerated during certain intervals, with significant year-over-year jumps occurring in 2022 and 2020.
Although spending was citywide, Medicaid payments for the National Codes Established for State Medicaid Agencies group were mainly limited to a few ZIP codes. In 2024, ZIP code 80033 reported $25,575,846, while 80212 recorded $173,842. These two ZIP codes together represented 100% of Wheat Ridge’s payments in this category during the year.
A small number of billing codes accounted for most Medicaid payments within the National Codes Established for State Medicaid Agencies category.
From 2023 to 2024, Medicaid payments for this service group in Wheat Ridge increased 46.3%, compared with an overall 4.9% change across all Medicaid claim categories in the city for 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 2023, making up roughly 18% of all U.S. health spending. This figure rose sharply from $613.5 billion in 2019, before the start of the COVID-19 pandemic.
The increase of about 40% over several years was mainly driven by expanded enrollment and greater utilization both during and after the pandemic.
Recent federal budget legislation under the Trump administration included major proposals for reducing federal Medicaid spending and changing program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid funding by more than $1 trillion over 10 years. It also introduces changes like work requirements and increased cost-sharing, which could reduce eligibility and funding for certain enrollees. As a result, states may bear more costs and federal Medicaid support growth may be capped, while the program continues to serve tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $12,312,604 | 18.4% |
| 2021 | $12,187,845 | -1% |
| 2022 | $15,729,586 | 29.1% |
| 2023 | $17,597,859 | 11.9% |
| 2024 | $25,749,689 | 46.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $25,749,689 | 55% |
| 2 | Evaluation and Management | $8,141,723 | 17.4% |
| 3 | Medicine Services and Procedures | $5,362,538 | 11.5% |
| 4 | Alcohol and Drug Abuse Treatment | $3,756,702 | 8% |
| 5 | Vision Services | $1,746,641 | 3.7% |
| 6 | Dental Services | $1,000,793 | 2.1% |
| 7 | Temporary National Codes (Non-Medicare) | $594,622 | 1.3% |
| 8 | Procedures / Professional Services | $203,617 | 0.4% |
| 9 | Pathology and Laboratory Procedures | $137,149 | 0.3% |
| 10 | Radiology Procedures | $79,402 | 0.2% |
| 11 | Surgery | $46,521 | 0.1% |
| 12 | Temporary Codes | $9,409 | <0.1% |
| 13 | Durable Medical Equipment | $2,902 | <0.1% |
| 14 | Medical And Surgical Supplies | $2,276 | <0.1% |
| 15 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $19,698,830 | 56 |
| T1019 | Personal care ser per 15 min | $2,366,127 | 41 |
| T2021 | Day habil waiver per 15 min | $2,270,109 | 52 |
| T1017 | Targeted case management | $678,530 | 91 |
| T2003 | N-et; encounter/trip | $508,338 | 40 |
| T2031 | Assist living waiver/diem | $143,839 | 4 |
| T2015 | Habil prevoc waiver per hr | $48,609 | 12 |
| T2030 | Assist living waiver/month | $30,002 | 1 |
| T2004 | N-et; commerc carrier pass | $5,301 | 4 |
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.
