Pikeville sees $4,549,310 in Medicaid payments for state-specific national codes in 2024

In 2024, Medicaid providers in Pikeville billed $4,549,310 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. That amount represents a 6.2% increase from 2023, when the same services generated $4,283,733 in claims.

Medicaid operates as a public health insurance program administered by states and jointly funded by federal and state governments. It provides coverage for low-income families and individuals, as well as seniors, children, and people with disabilities, making it one of the country’s largest health care programs.

Since Medicaid dollars are taxpayer funded, fluctuations in billing reflect how public health resources are distributed within a community.

The “National Codes Established for State Medicaid Agencies” group includes Medicaid-billed services defined by the nature of the care, based on standardized HCPCS and CPT code groupings. This analysis assigned each billing code to a single service category by using specific code prefixes and ranges, allowing related services to be tracked together and ranked accurately while avoiding double counting.

Although Medicaid payments climbed in several service groups, National Codes Established for State Medicaid Agencies placed fifth in Pikeville for total Medicaid payments in 2024.

Statewide in Kentucky, the National Codes Established for State Medicaid Agencies group held the top spot for Medicaid payment totals in 2024.

From 2019 through 2024, Medicaid spending connected to the National Codes Established for State Medicaid Agencies category in Pikeville grew by $1,453,040, or 46.9%. Certain years, including 2020 and 2021, saw periods of accelerated growth in spending.

Payments in this category were distributed citywide, though most were concentrated in a small number of ZIP codes. In 2024, ZIP code 41501 accounted for $4,549,309—making up 100% of the city’s Medicaid payments for this category that year.

Within this group, Medicaid reimbursements were heavily focused on a select subset of billing codes.

Between 2024 and 2023, Medicaid payments in this category in Pikeville rose 6.2%, while the increase across all Medicaid claim categories for the city was 1.6% during the same timeframe.

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

This surge reflects growth of about 40% over several years, attributed primarily to increased enrollment and utilization during and after the pandemic.

Recent federal budget activity under the Trump administration has introduced major proposals to cut federal Medicaid outlays and adjust the program’s structure. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next decade and includes policies such as work requirements and expanded cost-sharing, which could impact coverage and funding for certain recipients. These initiatives are projected to shift more costs to states and may limit the rate of federal Medicaid funding growth, even as the program continues to support millions nationwide.

Note: HCPCS codes are included to give context to the category. The totals and rankings referenced here use standardized service groups instead of individual billing codes.

Data for this report are sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the original data here.