Silver Spring Medicaid providers billed $53,954,487 in 2024 for services designated within the National Codes Established for State Medicaid Agencies, according to information from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amounted to a 6.9% increase from 2023, when the total was $50,483,599 for the same service group.
Medicaid is a state-administered public health insurance program funded through a partnership of federal and state governments. It provides health coverage for low-income individuals and families, seniors, children, and people with disabilities, making it one of the key components of the U.S. health care system.
As Medicaid funding comes from taxpayers, local billing fluctuations demonstrate how public health care resources are distributed within a community.
The “National Codes Established for State Medicaid Agencies” group consists of Medicaid-billed services classified by care type, based on standardized HCPCS and CPT code sets. In this analysis, each billing code was allocated to a single service grouping by code prefix and numeric range, allowing for consistent category tracking while avoiding double counting and maintaining reliable rankings over time.
Medicaid expenditures increased across several service groups, with National Codes Established for State Medicaid Agencies leading all categories in Silver Spring for total Medicaid payments in 2024.
On a statewide basis, the National Codes Established for State Medicaid Agencies placed fourth among Medicaid service categories in Maryland for total payments in 2024.
From 2019 through 2024, Medicaid payments attributed to the National Codes Established for State Medicaid Agencies in Silver Spring rose by $20,264,391, representing a 60.1% increase. Growth accelerated during some years, with notable jumps in both 2023 and 2022.
While this category’s spending was distributed citywide, the majority of payments came from a few ZIP codes. In 2024, the largest Medicaid payments for this service group in Silver Spring were reported in ZIP code 20910 ($37,312,819), 20902 ($11,926,119), and 20906 ($3,548,753). Combined, these 3 ZIP codes made up 97.8% of all Medicaid spending in the category citywide in 2024.
Within the category, Medicaid payments were concentrated in a small number of individual billing codes.
For context, payments for the National Codes Established for State Medicaid Agencies in Silver Spring increased by 6.9% from 2023 to 2024, outpacing the 6.5% rise seen across all Medicaid claim categories in the city during that period.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending reached about $871.7 billion in fiscal 2023, accounting for roughly 18% of all national health spending, up significantly from $613.5 billion before the COVID-19 pandemic in 2019.
This growth amounts to an increase of approximately 40% over the span of a few years, mainly attributed to rising enrollment and greater service use during and after the pandemic period.
Recent federal budget actions under the Trump administration have included major proposals to cut federal Medicaid funding and alter the program’s structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to trim federal Medicaid funding by more than $1 trillion over the coming decade and brings policies such as work requirements and higher cost-sharing that may reduce benefits and funding for some enrollees. These adjustments are anticipated to transfer more expenses to states and slow the federal portion’s growth, even as Medicaid continues to serve tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $33,690,096 | 0.8% |
| 2021 | $34,817,466 | 3.3% |
| 2022 | $41,642,732 | 19.6% |
| 2023 | $50,483,598 | 21.2% |
| 2024 | $53,954,486 | 6.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $53,954,486 | 36.4% |
| 2 | Medicine Services and Procedures | $23,737,744 | 16% |
| 3 | Evaluation and Management | $23,641,890 | 15.9% |
| 4 | Alcohol and Drug Abuse Treatment | $21,252,400 | 14.3% |
| 5 | Temporary National Codes (Non-Medicare) | $9,735,463 | 6.6% |
| 6 | Radiology Procedures | $6,498,553 | 4.4% |
| 7 | Dental Services | $4,405,799 | 3% |
| 8 | Procedures / Professional Services | $1,884,754 | 1.3% |
| 9 | Surgery | $1,065,734 | 0.7% |
| 10 | Pathology and Laboratory Procedures | $902,271 | 0.6% |
| 11 | Medical And Surgical Supplies | $616,006 | 0.4% |
| 12 | Enteral and Parenteral Therapy | $249,380 | 0.2% |
| 13 | Vision Services | $141,938 | 0.1% |
| 14 | Administrative, Miscellaneous and Investigational | $121,281 | 0.1% |
| 15 | Drugs Administered Other than Oral Method | $75,557 | 0.1% |
| 16 | Temporary Codes | $56,682 | <0.1% |
| 17 | Orthotic Procedures and services | $11,056 | <0.1% |
| 18 | Chemotherapy Drugs | $2,539 | <0.1% |
| 19 | Diagnostic Radiology Services | $1,195 | <0.1% |
| 20 | Durable Medical Equipment | $850 | <0.1% |
| 21 | Other Services | $3 | <0.1% |
| 22 | Outpatient PPS | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1003 | Lpn/lvn services up to 15min | $24,059,256 | 36 |
| T2016 | Habil res waiver per diem | $20,442,469 | 38 |
| T1041 | Comm bh clinic svc per month | $3,585,430 | 72 |
| T2021 | Day habil waiver per 15 min | $3,066,808 | 24 |
| T2033 | Res, nos waiver per diem | $1,367,466 | 12 |
| T1017 | Targeted case management | $1,167,787 | 54 |
| T1023 | Program intake assessment | $65,250 | 9 |
| T2015 | Habil prevoc waiver per hr | $45,973 | 3 |
| T1015 | Clinic service | $45,751 | 9 |
| T4526 | Adult size pull-on med | $38,904 | 11 |
| T4527 | Adult size pull-on lg | $31,316 | 10 |
| T4541 | Large disposable underpad | $24,015 | 11 |
| T4543 | Adult disp brief/diap abv xl | $6,597 | 2 |
| T4535 | Disposable liner/shield/pad | $5,698 | 6 |
| T4528 | Adult size pull-on xl | $1,762 | 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.
