Pueblo West Medicaid providers billed $1,819,894 for services under the National Codes Established for State Medicaid Agencies category in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This represents a 17.6% rise from 2023, when providers billed $1,548,051 for these services.
Medicaid is a public insurance program operated by the states and funded by both federal and state governments. It covers low-income individuals and families, children, seniors, and people with disabilities, making it a major component of the U.S. health care system.
Since Medicaid funding comes from taxpayers, shifts in billing at the local level illustrate how community health care dollars are used.
The “National Codes Established for State Medicaid Agencies” category refers to a set of Medicaid-billed services defined by care type, organized according to standard HCPCS and CPT code groups. For this analysis, each billing code was assigned one service category using established code prefixes and number ranges, so that similar services could be examined collectively without double counting and with accurate rankings maintained over time.
Medicaid spending grew in various service categories, with National Codes Established for State Medicaid Agencies holding the top spot in Pueblo West by overall Medicaid payments for 2024.
Across Colorado, the National Codes Established for State Medicaid Agencies category was also first statewide in total Medicaid payments during 2024.
Between 2019 and 2024, Medicaid payments attributed to National Codes Established for State Medicaid Agencies in Pueblo West totaled an increase of $11,435,014, equal to 86.3%. Growth rates varied year to year, with substantial annual increases seen in 2023 and 2022.
Even though Medicaid payments for these services were distributed citywide, the majority were concentrated within a small number of ZIP codes. In 2024, ZIP code 81007 reported Medicaid payments amounting to $1,819,893, claiming 100% of all Medicaid spending tied to the National Codes Established for State Medicaid Agencies category in Pueblo West for the year.
Payments within this service category were also focused among a limited set of individual billing codes.
Comparing payment changes, Medicaid spending for National Codes Established for State Medicaid Agencies in Pueblo West rose by 17.6% between 2024 and 2023, while all Medicaid claim categories across the city increased by 27.9% during the same period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023, accounting for around 18% of total national health spending, which is a significant jump from roughly $613.5 billion in 2019, before the COVID-19 pandemic.
The nearly 40% increase over a few years was driven primarily by greater enrollment and utilization during and after the pandemic.
Recent federal budget legislation enacted during the Trump administration has included major proposals to reduce federal Medicaid support and change the structure of the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid spending by over $1 trillion for the next 10 years and introduces policies such as work requirements and expanded cost-sharing. These measures could decrease coverage and funding for some recipients, shift costs to states, and limit federal Medicaid growth even as millions of Americans still rely on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $13,254,908 | -2.2% |
| 2021 | $5,423,868 | -59.1% |
| 2022 | $1,630,105 | -69.9% |
| 2023 | $1,548,050 | -5% |
| 2024 | $1,819,893 | 17.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $1,819,893 | 37.4% |
| 2 | Evaluation and Management | $1,113,735 | 22.9% |
| 3 | Ambulance and Other Transport Services and Supplies | $754,800 | 15.5% |
| 4 | Medicine Services and Procedures | $693,549 | 14.2% |
| 5 | Surgery | $266,418 | 5.5% |
| 6 | Procedures / Professional Services | $139,100 | 2.9% |
| 7 | Vision Services | $40,385 | 0.8% |
| 8 | Dental Services | $32,842 | 0.7% |
| 9 | Radiology Procedures | $3,178 | 0.1% |
| 10 | Medical And Surgical Supplies | $2,794 | 0.1% |
| 11 | Outpatient PPS | $1,384 | <0.1% |
| 12 | Pathology and Laboratory Procedures | $1,127 | <0.1% |
| 13 | Durable Medical Equipment | $479 | <0.1% |
| 14 | Alcohol and Drug Abuse Treatment | $0 | <0.1% |
| 15 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| 16 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2031 | Assist living waiver/diem | $1,721,939 | 22 |
| T2021 | Day habil waiver per 15 min | $97,954 | 5 |
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.
