Montclair Medicaid payments reach $3,268,700 for National Codes Established for State Medicaid Agencies in 2024

Montclair Medicaid providers billed $3,268,700 for services identified within the National Codes Established for State Medicaid Agencies category in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflected a 2.5% uptick from 2023, when providers reported $3,190,267 in claims for the same services.

Medicaid, a public health insurance program managed by states and funded jointly by federal and state governments, insures low-income individuals and families, seniors, children, and people with disabilities. It remains a major component of the national health care system.

Because taxpayer dollars support Medicaid, local billing shifts reflect how communities allocate health care funds.

The “National Codes Established for State Medicaid Agencies” category includes an array of Medicaid services defined by service type, structured according to consistent HCPCS and CPT code classifications. Each billing code was placed into a designated service group, consolidating services by prefix and number range to ensure accurate year-over-year comparisons and eliminate double counting.

While increases in Medicaid spending were seen among several service categories, National Codes Established for State Medicaid Agencies placed fourth by overall Medicaid payments in Montclair during 2024.

Throughout California, this service category ranked as the state’s top Medicaid payments recipient in 2024.

From the five-year period leading to 2024, Medicaid payments tied to the National Codes Established for State Medicaid Agencies in Montclair grew by $1,267,448—a 63.3% increase. Growth was especially pronounced during certain periods, with substantial year-over-year gains noted for 2020 and 2021.

Though care within the National Codes Established for State Medicaid Agencies was billed citywide, most payments concentrated in select ZIP codes. In 2024, ZIP code 91763 accounted for $3,268,700—making up the entirety of Medicaid payments for this service category in Montclair.

Medicaid spending within this category also concentrated on a small set of billing codes.

By comparison, payments attributed to this category in Montclair increased 2.5% between 2024 and 2023. In contrast, total Medicaid claims citywide changed by just 0.1% for the period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures totaled roughly $871.7 billion for fiscal year 2023. This represented about 18% of total national health expenditures, a significant rise from approximately $613.5 billion in 2019 before the COVID-19 pandemic.

This growth marks a near 40% increase over a few years, largely fueled by changes in enrollment and usage during and after the pandemic era.

Federal budget provisions under the Trump administration have addressed sizable reductions to federal Medicaid funding and program restructuring. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to decrease federal Medicaid spending by more than $1 trillion over 10 years, and introduces measures such as work requirements and additional cost-sharing that could limit coverage for certain beneficiaries. These measures are expected to transfer more responsibility to states and constrain federal Medicaid funding growth as the program remains essential to tens of millions nationwide.

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.