Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows that Medicaid providers in Virginia Beach submitted $55,870,097 in 2024 for services in the National Codes Established for State Medicaid Agencies category. This represents a 10.4% increase compared to 2023, when payment claims totaled $50,609,136 for the same services.
Medicaid, funded in partnership by federal and state governments and operated by each state, provides coverage to low-income families and individuals, seniors, children, and people with disabilities, making it a primary component of the U.S. health care system.
As Medicaid payments utilize taxpayer dollars, fluctuations in local billing indicate how health care funds are distributed within communities.
The “National Codes Established for State Medicaid Agencies” designation encompasses a defined group of billed Medicaid services determined by specific care types, utilizing standardized HCPCS and CPT code groupings. Analysis assigned each billing code to a single service group based on code patterns, offering insights into grouped services while avoiding duplication or misleading rankings.
Among all Medicaid spending categories, National Codes Established for State Medicaid Agencies held the top position in Virginia Beach by total payments in 2024.
This category also ranked first statewide in Virginia by total paid Medicaid claims throughout 2024.
From 2019 through 2024, Medicaid payments connected to the National Codes Established for State Medicaid Agencies category in Virginia Beach rose by $19,520,350, or 53.7%. The data shows accelerated spending during some intervals, particularly with significant growth during 2023 and 2022.
Payments originating from National Codes Established for State Medicaid Agencies were distributed city-wide, but primarily concentrated in select ZIP codes. In 2024, leading ZIP codes for these Medicaid payments included 23462, contributing $28,701,513; 23452, contributing $19,712,072; and 23455, recording $4,290,935. Altogether, these 3 ZIP codes accounted for 94.3% of Medicaid payments within this service category for Virginia Beach during 2024.
A limited set of individual billing codes concentrated the majority of Medicaid payments within this category.
Between 2024 and 2023, Medicaid payments tied to the National Codes Established for State Medicaid Agencies category in Virginia Beach grew by 10.4%. In comparison, payment changes across all city Medicaid claim types saw an 8.4% increase over the same span.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending together reached approximately $871.7 billion for fiscal year 2023, making up nearly 18% of total national health expenditures. This figure climbed significantly from about $613.5 billion in 2019, before the onset of COVID-19.
The growth translates to an approximate 40% rise in just several years, largely stemming from expanded enrollment and increased utilization during and after the pandemic.
Recent federal budget measures under the Trump administration have incorporated notable efforts to decrease federal Medicaid contributions and change top-level program structures. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to trim federal Medicaid financing by over $1 trillion over the next ten years, in addition to rolling out rules like work requirements and higher cost-sharing, which could affect funding for some beneficiaries. These modifications are intended to allot more costs to individual states and slow the pace of federal Medicaid expansion, even as the program continues to support millions of people nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $36,349,746 | -6.9% |
| 2021 | $37,428,016 | 3% |
| 2022 | $42,968,735 | 14.8% |
| 2023 | $50,609,135 | 17.8% |
| 2024 | $55,870,097 | 10.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $55,870,097 | 33.2% |
| 2 | Alcohol and Drug Abuse Treatment | $47,539,353 | 28.3% |
| 3 | Medicine Services and Procedures | $25,552,044 | 15.2% |
| 4 | Evaluation and Management | $14,566,627 | 8.7% |
| 5 | Temporary National Codes (Non-Medicare) | $13,240,705 | 7.9% |
| 6 | Procedures / Professional Services | $3,795,416 | 2.3% |
| 7 | Radiology Procedures | $2,981,174 | 1.8% |
| 8 | Pathology and Laboratory Procedures | $1,108,076 | 0.7% |
| 9 | Enteral and Parenteral Therapy | $1,019,128 | 0.6% |
| 10 | Surgery | $930,618 | 0.6% |
| 11 | Ambulance and Other Transport Services and Supplies | $496,106 | 0.3% |
| 12 | Vision Services | $340,500 | 0.2% |
| 13 | Anesthesia | $258,901 | 0.2% |
| 14 | Medical And Surgical Supplies | $135,618 | 0.1% |
| 15 | Drugs Administered Other than Oral Method | $84,023 | <0.1% |
| 16 | Durable Medical Equipment | $66,737 | <0.1% |
| 17 | Orthotic Procedures and services | $34,390 | <0.1% |
| 18 | Temporary Codes | $18,384 | <0.1% |
| 19 | Dental Services | $11,491 | <0.1% |
| 20 | Diagnostic Radiology Services | $2,734 | <0.1% |
| 21 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 21 | Outpatient PPS | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1019 | Personal care ser per 15 min | $32,452,862 | 316 |
| T2033 | Res, nos waiver per diem | $10,223,032 | 24 |
| T1005 | Respite care service 15 min | $3,032,496 | 154 |
| T1017 | Targeted case management | $2,800,370 | 23 |
| T2021 | Day habil waiver per 15 min | $1,744,440 | 30 |
| T1003 | Lpn/lvn services up to 15min | $1,492,335 | 11 |
| T2005 | N-et; stretcher van | $1,462,967 | 46 |
| T2003 | N-et; encounter/trip | $1,268,306 | 108 |
| T2023 | Targeted case mgmt per month | $871,362 | 11 |
| T2022 | Case management, per month | $260,471 | 32 |
| T1023 | Program intake assessment | $165,222 | 31 |
| T1002 | Rn services up to 15 minutes | $45,387 | 7 |
| T1024 | Team evaluation & management | $28,787 | 15 |
| T1028 | Home environment assessment | $18,588 | 8 |
| T1027 | Family training & counseling | $3,465 | 3 |
| T2049 | N-et; stretcher van, mileage | $0 | 46 |
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.
