In 2024, Medicaid providers in Pflugerville charged $2,777,503 for services classified under the National Codes Established for State Medicaid Agencies, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents an 11.9% increase compared with 2023, when providers billed $2,481,635 for the same group of services.
Medicaid is a state-administered public health insurance program funded jointly by federal and state governments. It provides coverage for low-income individuals and families, children, seniors, and people with disabilities, making it a core component of the U.S. health care system.
As Medicaid payments are financed by taxpayers, fluctuations in local billing reflect how public health care dollars are distributed in a community.
The “National Codes Established for State Medicaid Agencies” category includes groups of Medicaid-billed services defined by the type of care provided, utilizing standardized HCPCS and CPT code groupings. In this analysis, each billing code was placed into a single service category based on consistent code prefixes and numeric ranges. This method enables analysis of related services together, prevents double counting, and maintains accuracy in ranking over time.
Medicaid spending grew in several service categories, with National Codes Established for State Medicaid Agencies ranking third in Pflugerville by total Medicaid payments in 2024.
Statewide in Texas, the National Codes Established for State Medicaid Agencies category held the second spot for total Medicaid payments in 2024.
Between 2019 and 2024, Medicaid payments linked to the National Codes Established for State Medicaid Agencies category in Pflugerville rose by $2,179,302, or 364.3%. Periods such as 2021 and 2022 saw particularly notable year-over-year increases.
Spending within this category in 2024 was distributed across Pflugerville, but the majority of payments were concentrated in a few ZIP codes. The highest total came from ZIP code 78660, which accounted for $2,777,503. The top 1 ZIP codes made up 100% of all Medicaid payments for National Codes Established for State Medicaid Agencies services in the city that year.
Additionally, within this service group, payments were focused among a small number of individual billing codes.
Comparing 2024 to 2023, Medicaid payments for National Codes Established for State Medicaid Agencies services in Pflugerville increased 11.9%, while citywide Medicaid claims for all categories changed by 7.4% during the same time frame.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached roughly $871.7 billion in fiscal year 2023, making up about 18% of all national health expenditures. This is a significant increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This represents a growth rate of about 40% over just a few years, due in large part to increased enrollment and greater utilization during and following the pandemic.
Recent federal budget laws enacted under the Trump administration have included major provisions reducing federal Medicaid funding and changing its structure. The “One Big Beautiful Bill Act,” enacted in 2025, is forecast to cut more than $1 trillion in federal Medicaid spending over the next decade. The act introduces measures such as work requirements and higher cost-sharing, which may lower coverage and funding for some recipients. These policy shifts are expected to transfer additional costs to states and curb federal Medicaid growth, even as the program continues serving millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $598,201 | -50.1% |
| 2021 | $960,024 | 60.5% |
| 2022 | $2,030,714 | 111.5% |
| 2023 | $2,481,635 | 22.2% |
| 2024 | $2,777,503 | 11.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $5,634,888 | 38.2% |
| 2 | Ambulance and Other Transport Services and Supplies | $4,517,703 | 30.6% |
| 3 | National Codes Established for State Medicaid Agencies | $2,777,503 | 18.8% |
| 4 | Alcohol and Drug Abuse Treatment | $949,733 | 6.4% |
| 5 | Evaluation and Management | $502,389 | 3.4% |
| 6 | Dental Services | $289,346 | 2% |
| 7 | Medicine Services and Procedures | $57,218 | 0.4% |
| 8 | Vision Services | $25,367 | 0.2% |
| 9 | Pathology and Laboratory Procedures | $8,862 | 0.1% |
| 10 | Surgery | $4,972 | <0.1% |
| 11 | Radiology Procedures | $1,179 | <0.1% |
| 12 | Procedures / Professional Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $2,252,796 | 48 |
| T1019 | Personal care ser per 15 min | $267,071 | 7 |
| T1005 | Respite care service 15 min | $215,652 | 12 |
| T2003 | N-et; encounter/trip | $23,871 | 2 |
| T1002 | Rn services up to 15 minutes | $13,483 | 9 |
| T1502 | Medication admin visit | $2,585 | 3 |
| T1003 | Lpn/lvn services up to 15min | $2,041 | 5 |
Note: HCPCS codes are shown for context within the category. Category totals and rankings in this article are based on standardized service groupings rather than individual billing codes.
Information in this article was obtained from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data can be found here.
