Boston Medicaid spending for national code services climbs to $191.6 million in 2024

In 2024, Medicaid providers in Boston recorded $191,607,094 in billings for services categorized under the National Codes Established for State Medicaid Agencies, federal data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This total reflects a 9% rise from 2023, when Medicaid claims for these services reached $175,758,036.

Medicaid is a state-administered health insurance initiative supported by both federal and state government funding. The program provides health coverage to low-income Americans, seniors, children, and people with disabilities, remaining a major part of the national health care infrastructure.

Because taxpayer dollars fund Medicaid, fluctuations in billing levels at the local level indicate how health care funding is used within a community.

The “National Codes Established for State Medicaid Agencies” group includes Medicaid-billed services identified by specific care types, with standardized HCPCS and CPT code assignments. For these findings, each code was attributed to one service category, using uniform code prefixes and number ranges to group related services, ensuring no duplicates and allowing for accurate trend tracking over time.

While Medicaid spending grew across various service groups, National Codes Established for State Medicaid Agencies held the top spot for total Medicaid payments in Boston in 2024.

Across Massachusetts, spending for the National Codes Established for State Medicaid Agencies category was also the highest among all service categories for 2024.

Medicaid payments associated with the National Codes Established for State Medicaid Agencies group in Boston increased by $28,133,141, or 17.2%, during the five years before 2024. Accelerated spending growth was particularly noted in specific years like 2022 and 2020.

Although these payments were made throughout Boston, most spending was reported in a small number of ZIP codes in 2024. The largest Medicaid payments went to providers in 02109 ($157,603,183), 02118 ($13,918,346), and 02111 ($8,534,188), making up 94% of all payments in this category citywide for the year.

Within this Medicaid service group, a limited pool of billing codes comprised the majority of payments.

Between 2024 and 2023, Medicaid payments related to this category in Boston rose by 9%, while all Medicaid claim categories in the city saw an overall year-over-year change of 12.7%.

Data from the Centers for Medicare & Medicaid Services indicates that total Medicaid expenditures nationwide reached approximately $871.7 billion in fiscal year 2023, representing about 18% of all U.S. health spending and reflecting a sharp rise from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This growth equals roughly a 40% increase within a few years, largely due to higher enrollment and increased utilization during and after the pandemic.

Recent federal budget measures under the Trump administration have included major proposals aiming to reduce Medicaid spending and restructure the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut over $1 trillion in federal Medicaid allocations during the next decade and adds requirements like mandatory work participation and higher cost-sharing, potentially narrowing eligibility and shifting greater costs to states despite continued high enrollment.

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.