Alton Medicaid payments for national code services rise to $4.2 million in 2024

Providers in Alton submitted $4,214,464 in Medicaid claims for services under the National Codes Established for State Medicaid Agencies category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 5.6% increase over 2023, when claimed spending for these services stood at $3,992,743.

Medicaid, one of the largest health insurance programs in the country, is administered by states with joint funding from federal and state governments. It provides coverage for low-income residents, children, seniors and people with disabilities.

As Medicaid spending is publicly funded, fluctuations in local billing levels offer insight into how community health care dollars are spent.

The National Codes Established for State Medicaid Agencies category covers a variety of Medicaid-billed services, based on defined groups using standardized HCPCS and CPT code systems. In preparation for this analysis, each code was mapped to a single service grouping using code prefixes and number ranges, to ensure related services could be reviewed and to avoid duplication and ensure rankings are accurate over time.

Among Alton Medicaid service categories, National Codes Established for State Medicaid Agencies had the highest payment total in 2024.

Statewide in Illinois, payments for National Codes Established for State Medicaid Agencies likewise led all Medicaid service categories in 2024 by total amount.

From 2019 to 2024, Medicaid payments in Alton for this service category rose by $257,714, or 5.8%. Periods of accelerated growth occurred, with the highest year-over-year payment increases in 2020 and 2022.

Medicaid payments in this category were not evenly spread throughout Alton and tended to cluster in specific ZIP codes. In 2024, the 62002 ZIP code accounted for the entire category’s Medicaid payments locally, representing $4,214,464—meaning one ZIP code made up 100% of these Medicaid payments in Alton that year.

Within the category, a small number of individual billing codes received most of the Medicaid dollars.

In comparison, National Codes Established for State Medicaid Agencies payments in Alton increased by 5.6% from 2023 to 2024, while overall Medicaid claim payments for all categories in Alton grew by 8.2% in the same period.

According to the Centers for Medicare & Medicaid Services, combined spending at the federal and state levels reached approximately $871.7 billion in 2023 for Medicaid, accounting for about 18% of national health expenditures. This reflects a sharp increase from $613.5 billion in 2019, just before the COVID-19 pandemic.

That means Medicaid grew by roughly 40% over several years, with most of the rise driven by greater enrollment and increased health care use during and after the pandemic period.

Federal budget measures under the Trump administration have introduced major proposals that reduce federal funding for Medicaid and overhaul some program structures. For instance, the “One Big Beautiful Bill Act,” signed in 2025, is expected to cut more than $1 trillion from federal Medicaid support in the next 10 years, adding policies such as work requirements and additional cost-sharing for certain enrollees. These changes could shift a greater share of costs onto states while holding down increases in federal funding, even though the program continues to serve millions of Americans 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.