In 2024, Grand Junction Medicaid providers billed $62,223,402 for services under the National Codes Established for State Medicaid Agencies category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This amounted to a 14.9% increase from 2023, when billing for the same type of service reached $54,164,653.
Medicaid operates as a state-run, jointly federal- and state-funded public health insurance program. It provides coverage for low-income people and families, older adults, children, and individuals with disabilities, playing a significant role in the U.S. health care system.
Because Medicaid payments are sourced from local, state and federal taxes, shifts in community billing reflect how public health care resources are distributed at the local level.
The “National Codes Established for State Medicaid Agencies” designation includes a set of Medicaid services organized by service type, based on predetermined HCPCS and CPT code groupings. This analysis assigned every billing code into a single service group using systematic prefixes and numerical ranges, which allows for transparent comparisons across years, avoids double counting, and upholds accurate rankings.
While Medicaid spending grew across multiple categories, National Codes Established for State Medicaid Agencies led all categories in Grand Junction for total Medicaid payments in 2024.
Statewide in Colorado, the National Codes Established for State Medicaid Agencies services category also had the highest Medicaid payment total for 2024.
From 2019 through 2024, Medicaid payments linked to National Codes Established for State Medicaid Agencies in Grand Junction climbed $3,510,116, representing a 6% gain. Growth accelerated during specific years, most notably with higher year-over-year spending in 2023 and 2022.
Although Medicaid-covered care in this category was provided citywide, spending largely concentrated in a few ZIP codes. In 2024, payments were highest in ZIP code 81501 ($25,562,965), followed by 81504 ($18,041,311) and 81506 ($16,281,527). Combined, these 3 ZIP codes represented 96.2% of all the category’s Medicaid payments in Grand Junction that year.
Within the National Codes Established for State Medicaid Agencies group, spending also coalesced around a relatively small set of individual billing codes.
To compare, Medicaid payments tied to this category in Grand Junction increased 14.9% from 2023 to 2024, while spending across all Medicaid claim categories in the city went up by 12.2% in that period.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid expenditures reached about $871.7 billion nationwide in fiscal year 2023, accounting for roughly 18% of the country’s total health costs. That marks a sharp rise from $613.5 billion in 2019, before the COVID-19 pandemic.
This change represents nearly 40% growth in just a few years, driven primarily by greater program enrollment and increased use of services during and after the pandemic.
In recent years, federal budget measures during the Trump administration have introduced major proposals aimed at reducing and restructuring Medicaid at the national level. Notably, the “One Big Beautiful Bill Act,” signed into law in 2025, is estimated to reduce federal Medicaid funding by over $1 trillion during the next decade, adding work requirements and more cost-sharing rules that could cut coverage and federal funding for some enrollees. These policies are expected to create additional financial responsibility for states and limit future increases in federal Medicaid funding, though tens of millions of Americans continue to rely on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $58,713,285 | -0.5% |
| 2021 | $49,349,128 | -15.9% |
| 2022 | $48,386,430 | -2% |
| 2023 | $54,164,653 | 11.9% |
| 2024 | $62,223,401 | 14.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $62,223,401 | 38.8% |
| 2 | Alcohol and Drug Abuse Treatment | $44,295,412 | 27.6% |
| 3 | Ambulance and Other Transport Services and Supplies | $18,106,415 | 11.3% |
| 4 | Evaluation and Management | $12,689,509 | 7.9% |
| 5 | Medicine Services and Procedures | $11,116,576 | 6.9% |
| 6 | Temporary National Codes (Non-Medicare) | $5,916,107 | 3.7% |
| 7 | Dental Services | $1,929,871 | 1.2% |
| 8 | Durable Medical Equipment | $1,246,444 | 0.8% |
| 9 | Vision Services | $790,800 | 0.5% |
| 10 | Surgery | $515,923 | 0.3% |
| 11 | Medical And Surgical Supplies | $498,406 | 0.3% |
| 12 | Pathology and Laboratory Procedures | $345,886 | 0.2% |
| 13 | Drugs Administered Other than Oral Method | $157,925 | 0.1% |
| 14 | Procedures / Professional Services | $153,373 | 0.1% |
| 15 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $138,178 | 0.1% |
| 16 | Radiology Procedures | $118,177 | 0.1% |
| 17 | Enteral and Parenteral Therapy | $32,617 | <0.1% |
| 18 | Anesthesia | $25,571 | <0.1% |
| 19 | Chemotherapy Drugs | $12,672 | <0.1% |
| 20 | Orthotic Procedures and services | $6,161 | <0.1% |
| 21 | Temporary Codes | $4 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $21,399,203 | 57 |
| T2033 | Res, nos waiver per diem | $8,940,710 | 11 |
| T2023 | Targeted case mgmt per month | $6,710,230 | 11 |
| T1019 | Personal care ser per 15 min | $6,618,960 | 92 |
| T2021 | Day habil waiver per 15 min | $6,292,842 | 105 |
| T2031 | Assist living waiver/diem | $5,136,896 | 49 |
| T2019 | Habil sup empl waiver 15min | $1,957,090 | 37 |
| T1017 | Targeted case management | $1,725,687 | 55 |
| T2003 | N-et; encounter/trip | $1,287,364 | 98 |
| T2024 | Serv asmnt/care plan waiver | $1,075,096 | 34 |
| T4535 | Disposable liner/shield/pad | $289,996 | 21 |
| T4527 | Adult size pull-on lg | $198,453 | 21 |
| T4526 | Adult size pull-on med | $190,184 | 21 |
| T4528 | Adult size pull-on xl | $166,105 | 21 |
| T4534 | Youth size pull-on | $73,549 | 21 |
| T4544 | Adlt disp und/pull on abv xl | $64,617 | 12 |
| T4523 | Adult size brief/diaper lg | $36,771 | 9 |
| T4522 | Adult size brief/diaper med | $29,177 | 9 |
| T4525 | Adult size pull-on sm | $26,841 | 12 |
| T4541 | Large disposable underpad | $3,620 | 11 |
Note: HCPCS codes are listed for context within the category. Total and ranks in this article are based on grouped categories of service, not individual billing codes.
The data in this article is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. To view the original data, click here.
