Edwardsville Medicaid spending on state agency codes totals $6,572 in 2024

In 2024, Edwardsville Medicaid providers billed $6,572 for services under the National Codes Established for State Medicaid Agencies, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This was a 16.8% rise from 2023, when those providers filed $5,625 in claims for this service category.

Medicaid is administered by states and financed through federal and state contributions. It serves low-income individuals and families, seniors, children, and those with disabilities, making it among the largest components of the nation’s health care system.

Since Medicaid is taxpayer-funded, shifts in local billing volumes highlight how health care funds are allocated in a community.

The “National Codes Established for State Medicaid Agencies” designation represents a set of Medicaid-billed services defined by the care type, using standard HCPCS and CPT code groups. For this report, each billing code was matched to a single service category using uniform code prefixes and numeric intervals to allow grouped analysis and prevent duplicate counts, preserving accuracy in rankings over time.

While Medicaid spending rose across several service groups, payments for National Codes Established for State Medicaid Agencies ranked third by amount in Edwardsville in 2024.

Statewide in Illinois, National Codes Established for State Medicaid Agencies ranked first among Medicaid categories for total payments in 2024.

Looking at the five years before 2024, Medicaid-related payments for National Codes Established for State Medicaid Agencies in Edwardsville climbed by $46,999, or 87.7%. Growth accelerated at points, with significant year-to-year gains in 2021 and 2022.

Although these Medicaid payments were distributed throughout the city, the amounts were concentrated in just a handful of ZIP codes. In 2024, ZIP code 62025 saw the highest payments for National Codes Established for State Medicaid Agencies at $6,571. Altogether, the leading ZIP code accounted for 100% of these payments in Edwardsville that year.

Within this Medicaid group, payments also focused on a small set of specific billing codes.

For context, Medicaid payments for National Codes Established for State Medicaid Agencies in Edwardsville rose 16.8% from 2023 to 2024, while payments for all categories in the city grew 16.6% over the same span.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached about $871.7 billion in fiscal 2023, making up roughly 18% of all U.S. health expenditures. That’s up sharply from around $613.5 billion in 2019, prior to the COVID-19 pandemic.

This roughly 40% growth over a few years was largely driven by rising enrollment and greater use of services during and after the pandemic period.

Recent federal budget measures during the Trump administration included major proposals to cut federal Medicaid funding and make structural changes to the program. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid funding by more than $1 trillion over the next decade, introducing work requirements and higher cost-sharing that could reduce both coverage and funding for some groups. These shifts are likely to place more financial responsibility on states and constrain federal Medicaid growth, even as the program continues providing coverage for tens of millions of Americans.

Note: HCPCS codes are provided for reference within this category. For this article, category totals and rankings are determined by groupings of standardized services, not individual billing codes.

This information was sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original data source can be accessed here.