Sebago Medicaid payments for National Codes Established services rise 1.6% to $7.9M in 2024

In 2024, Medicaid providers in Sebago reported $7,899,958 in billing for services categorized as National Codes Established for State Medicaid Agencies, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 1.6% rise compared to 2023, when $7,773,226 was billed for the same service group.

Medicaid operates as a public health insurance program managed by states and financed through both federal and state contributions. The program serves low-income individuals and families, seniors, children, and people with disabilities, making it a critical element of the nation’s health care structure.

Since Medicaid financing is sourced from taxpayers, fluctuations in local billing levels illustrate the allocation of public health care spending within the community.

The “National Codes Established for State Medicaid Agencies” group identifies a segment of billed Medicaid services defined by specific care types, with standardized HCPCS and CPT codes used to group services. For this analysis, each code was assigned to only one service group, applying consistent code prefixes and numbers to keep similar services together and ensure results were not overstated or misranked over multiple years.

Across multiple categories, Medicaid spending grew, but National Codes Established for State Medicaid Agencies topped the list by total Medicaid payments in Sebago during 2024.

At the statewide level, Maine also saw National Codes Established for State Medicaid Agencies rank first in Medicaid payments for 2024.

Medicaid payments related to the National Codes Established for State Medicaid Agencies group in Sebago climbed by $594,514 over five years through 2024—an overall increase of 8.1%. Spending growth was particularly strong during some periods, including 2020 and 2023, when notable year-over-year rises were reported.

The distribution of payments for this category across Sebago was concentrated in a few ZIP codes. In 2024, ZIP code 04029 accounted for $7,899,958, with the top ZIP code representing 100% of Medicaid payments in the category in Sebago for the year.

This concentration was also seen in billing codes—only a small number of codes generated most of the payments within the category.

Between 2024 and 2023, Medicaid payments in Sebago for this category increased by 1.6%, compared with a 1.3% rise observed for all Medicaid claims citywide during the same period.

The Centers for Medicare & Medicaid Services reports total federal and state Medicaid spending reached about $871.7 billion in fiscal year 2023. That amounted to roughly 18% of the nation’s total health expenditures, a significant rise from $613.5 billion spent in 2019 before the COVID-19 pandemic.

This marks more than 40% growth in recent years, driven by larger enrollment and greater service use due to the pandemic and its aftereffects.

Recent changes to federal budget policy enacted during the Trump administration brought major Medicaid reform efforts. The “One Big Beautiful Bill Act,” passed in 2025, is estimated to reduce federal Medicaid funding by more than $1 trillion over the next 10 years and introduces new requirements such as work and cost-sharing provisions, which could lower coverage and funding for some recipients. Such measures are expected to move more funding responsibility to states and curb growth in federal spending as Medicaid continues to provide care to millions of Americans.

Note: HCPCS codes are provided for transparency within the group. Group totals and rankings in this article rely on standardized service collections rather than specific billing codes.

This article’s information is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the original data here.