Caldwell sees $553,009 in Medicaid payments for national code services in 2024

In 2024, Caldwell Medicaid providers billed a total of $553,009 for services classified within the National Codes Established for State Medicaid Agencies category, based on the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented an 80% rise from 2023, when claims for this category amounted to $307,311.

Medicaid is a public health insurance program managed by states and funded through both federal and state resources. The program insures low-income individuals and families, seniors, children, and people with disabilities, making it a major component of the U.S. health care system.

Because Medicaid is taxpayer-funded, local changes in billing can indicate how public health care funds are used within a community.

The “National Codes Established for State Medicaid Agencies” category includes Medicaid-billed services as defined by types of care, based on standardized HCPCS and CPT code groups. For this analysis, each billing code fell into one service category by using consistent code prefixes and numbering, which grouped similar services for review, prevented duplicate counts and kept accurate rankings by year.

Although Medicaid outlays rose in several service categories, National Codes Established for State Medicaid Agencies accounted for the largest Medicaid payments in Caldwell in 2024.

Within New Jersey, the National Codes Established for State Medicaid Agencies category stood as the second highest statewide for total Medicaid payments in 2024.

In the five years leading up to 2024, Medicaid payments tied to National Codes Established for State Medicaid Agencies in Caldwell rose by $553,009, or 0%. Growth in spending accelerated at certain times, with significant year-over-year increases recorded in 2023 and 2022.

Spending in the National Codes Established for State Medicaid Agencies category was spread throughout the city, but most payments went to a limited number of ZIP codes. In 2024, the highest total, $553,009, was in ZIP code 07006. This ZIP code alone represented 100% of all Medicaid payments for this service group in Caldwell that year.

Within the category, Medicaid payments concentrated among a small subset of billing codes.

For context, Medicaid payments in Caldwell for the National Codes Established for State Medicaid Agencies increased 80% from 2023 to 2024; across all Medicaid claim types in Caldwell, there was a 93.4% change in the same period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached about $871.7 billion for fiscal year 2023, making up roughly 18% of total U.S. health costs—a sharp increase from about $613.5 billion in 2019, before the COVID-19 pandemic.

The rise amounts to an approximate 40% increase within a few years, due primarily to expanded enrollment and greater use during and after the pandemic.

Recent federal budgeting signed into law during the Trump administration has introduced significant plans to cut federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” finalized in 2025, is projected to reduce federal Medicaid spending by over $1 trillion in the coming decade and implements policies such as work requirements and higher cost-sharing that could restrict coverage and funding for some Medicaid users. These actions are likely to shift further costs to states and restrict federal Medicaid growth, even as the program continues to cover millions of Americans.

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.