In 2024, Medicaid providers in Detroit billed $69,478,089 for services categorized under the National Codes Established for State Medicaid Agencies, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This marked an 8.5% jump from 2023, when spending on these services reached $64,051,949.
Medicaid, a joint state and federal public health insurance program, provides coverage for low-income people and families, seniors, children, and individuals with disabilities, making it a major component of the U.S. health care system. More details about its funding can be found here.
Since Medicaid payments derive from taxpayer contributions, local billing trends reflect how public health care funding is divided among communities.
The “National Codes Established for State Medicaid Agencies” category comprises a set of Medicaid-covered services organized by the type of care delivered and grouped by standardized HCPCS and CPT codes. For this study, each billing code was consistently assigned to a single service category using set code prefixes and ranges—allowing for accurate aggregation of related care categories, preventing overlap and maintaining valid rankings.
Medicaid spending expanded across service lines, with National Codes Established for State Medicaid Agencies ranking as the third largest category for total Medicaid payments in Detroit in 2024.
Statewide, in Michigan, National Codes Established for State Medicaid Agencies placed second for total Medicaid payments in 2024.
Between 2019 and 2024, Detroit saw Medicaid payments for this service category grow by $10,015,962, or 16.8%. Several periods, notably 2023 and 2021, saw more pronounced annual increases.
While these Medicaid payments were made citywide, a few ZIP codes accounted for most of the spending. In 2024, ZIP code 48207 saw $49,177,914, 48238 had $6,443,859, and 48214 received $3,347,560. Altogether, the 3 leading ZIP codes represented 84.9% of all related Medicaid payments in Detroit that year.
A limited set of individual billing codes generated the majority of payments within this category.
Between 2024 and 2023, Medicaid payments for these services in Detroit rose 8.5%, compared to a 7.8% increase for all Medicaid claim categories in the city during the same window.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures totaled about $871.7 billion in fiscal 2023, making up approximately 18% of the nation’s health expenditures. That’s a significant increase from $613.5 billion in 2019, before the COVID-19 pandemic.
This growth—roughly 40% in only a few years—has largely come from increased enrollment and use of services during and after the pandemic.
Recent federal budget measures adopted under the Trump administration include major plans to decrease federal Medicaid contributions and alter the program’s structure. The “One Big Beautiful Bill Act,” passed in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over a decade, introducing stricter work requirements and more cost-sharing that could affect coverage and funding for certain participants. These changes are projected to transfer additional costs to states and limit increases in federal Medicaid aid, even as the program continues providing for tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $59,462,127 | -6.1% |
| 2021 | $61,978,714 | 4.2% |
| 2022 | $59,557,102 | -3.9% |
| 2023 | $64,051,948 | 7.5% |
| 2024 | $69,478,088 | 8.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $127,961,169 | 27.7% |
| 2 | Alcohol and Drug Abuse Treatment | $82,930,094 | 18% |
| 3 | National Codes Established for State Medicaid Agencies | $69,478,088 | 15.1% |
| 4 | Medicine Services and Procedures | $62,842,942 | 13.6% |
| 5 | Procedures / Professional Services | $24,295,240 | 5.3% |
| 6 | Surgery | $19,460,063 | 4.2% |
| 7 | Radiology Procedures | $14,850,879 | 3.2% |
| 8 | Medical And Surgical Supplies | $10,481,336 | 2.3% |
| 9 | Pathology and Laboratory Procedures | $10,178,731 | 2.2% |
| 10 | Ambulance and Other Transport Services and Supplies | $9,688,290 | 2.1% |
| 11 | Temporary National Codes (Non-Medicare) | $7,401,799 | 1.6% |
| 12 | Chemotherapy Drugs | $4,964,109 | 1.1% |
| 13 | Dental Services | $4,560,478 | 1% |
| 14 | Administrative, Miscellaneous and Investigational | $3,607,284 | 0.8% |
| 15 | Drugs Administered Other than Oral Method | $2,969,028 | 0.6% |
| 16 | Durable Medical Equipment | $1,796,723 | 0.4% |
| 17 | Anesthesia | $1,646,304 | 0.4% |
| 18 | Temporary Codes | $991,632 | 0.2% |
| 19 | Outpatient PPS | $453,436 | 0.1% |
| 20 | Pathology and Laboratory Services | $347,575 | 0.1% |
| 21 | Enteral and Parenteral Therapy | $281,512 | 0.1% |
| 22 | Vision Services | $60,882 | <0.1% |
| 23 | Orthotic Procedures and services | $34,794 | <0.1% |
| 24 | Hearing Services | $29,427 | <0.1% |
| 25 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $7,836 | <0.1% |
| 26 | Coronavirus Diagnostic Panel | $2,697 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1017 | Targeted case management | $31,726,971 | 141 |
| T1019 | Personal care ser per 15 min | $27,192,535 | 46 |
| T2022 | Case management, per month | $4,725,745 | 18 |
| T1012 | Alcohol/substance abuse skil | $2,280,537 | 95 |
| T1020 | Personal care ser per diem | $1,996,967 | 38 |
| T1001 | Nursing assessment/evaluatn | $826,351 | 69 |
| T2003 | N-et; encounter/trip | $455,394 | 28 |
| T1002 | Rn services up to 15 minutes | $167,853 | 50 |
| T1023 | Program intake assessment | $105,095 | 6 |
| T1040 | Comm bh clinic svc per diem | $636 | 34 |
Note: HCPCS codes appear for reference within the category. Totals and rankings are based on standardized groupings, not individual billing codes.
This article draws data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Source data is available here.
