Windham sees $21,043,581 in Medicaid spending for National Codes Established for State Medicaid Agencies in 2024

In 2024, Medicaid providers in Windham billed a total of $21,043,581 for services categorized under the National Codes Established for State Medicaid Agencies, according to figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The amount was 39.6% higher than in 2023, when claims totaled $15,079,227 for this classification of service.

Medicaid, a public health insurance initiative administered by states and funded through both federal and state funds, helps provide coverage for low-income families and individuals, older adults, children, and people with disabilities. The program is a significant component of the national health system.

Because Medicaid funding comes through individual taxpayers, variations in spending at the local level reveal how healthcare funds are used within a community.

The “National Codes Established for State Medicaid Agencies” label refers to a set of Medicaid services defined by consistent, standardized HCPCS and CPT code groupings, determined by care type. For this summary, analysts assigned each billing code to one primary service group through unified prefix and numerical system rules, allowing the grouping of similar services, minimizing duplicate counts, and supporting precise comparisons over time.

While several categories experienced increased Medicaid spending, the National Codes Established for State Medicaid Agencies category led in Windham for total 2024 Medicaid payments.

The category also ranked first across Maine by total Medicaid spending in 2024.

Over the five years preceding 2024, Medicaid payments related to the National Codes Established for State Medicaid Agencies in Windham grew by $19,548,916, amounting to a 1,307.9% increase. Spending notably accelerated over some periods, with sharp increases documented in both 2023 and 2022.

Although National Codes Established for State Medicaid Agencies payments were distributed citywide, the bulk of spending was concentrated in a small number of ZIP codes. The highest payments in 2024 came from ZIP code 04062, which totaled $21,043,581. That single ZIP code represented 100% of all Medicaid payments in Windham for this category during the year.

Additionally, only a few individual billing codes dominated Medicaid spending within the National Codes Established for State Medicaid Agencies group.

Specifically, between 2024 and 2023, payments tied to National Codes Established for State Medicaid Agencies rose 39.6% in Windham, compared to a 29% overall rise among all Medicaid claim types locally for the same timeframe.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending collectively reached about $871.7 billion during the 2023 fiscal year, comprising roughly 18% of all health expenditures nationwide—an increase from about $613.5 billion in 2019, prior to the COVID-19 pandemic.

This change represents about 40% growth over several years, mostly due to wider coverage and increased usage after the onset of the pandemic.

Recent federal budget actions under the Trump administration introduced major plans to trim federal contributions to Medicaid and alter the program’s design. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid outlays by over $1 trillion in the coming decade, enacting measures such as work requirements and heightened cost-sharing that could restrict some enrollment and coverage. These adjustments are likely to shift additional obligations to individual states and restrain the expansion of federal Medicaid resources, although the program continues to cover tens of millions of Americans.

Note: HCPCS codes are provided for context within the service category. Totals and category rankings in this article are based on aggregated service groupings, not individual billing codes.

The reported information in this article draws from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the source data here.