Medicaid payments for National Codes Established for State Medicaid Agencies climb to $4,589,781 in North Plainfield in 2024

In 2024, Medicaid providers in North Plainfield billed $4,589,781 for services grouped under the National Codes Established for State Medicaid Agencies, as reported in the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount shows a 10.7% gain from 2023, when $4,146,073 was submitted for the same service category.

Medicaid is administered by states and funded jointly by federal and state governments. It covers eligible low-income individuals, seniors, children, and people with disabilities, making it a significant component of the American health care system.

Since taxpayer dollars fund Medicaid, shifts in local billing reflect how health care resources are used in each community.

The “National Codes Established for State Medicaid Agencies” group encompasses services defined by care type, using standardized HCPCS and CPT code clusters. In this review, each code was matched to one service group using set code prefixes and numbers, allowing related services to be tracked and ranked accurately over time without repeated counts.

While total Medicaid spending grew across a range of categories, National Codes Established for State Medicaid Agencies represented the top Medicaid payment category in North Plainfield for 2024.

Statewide in New Jersey, National Codes Established for State Medicaid Agencies was the second largest category for Medicaid payments in 2024.

Looking at the five-year period leading up to 2024, North Plainfield’s Medicaid payments linked to the National Codes Established for State Medicaid Agencies climbed by $3,396,095 or 284.5%. Growth rates were greatest during specific intervals, including significant year-over-year gains in 2022 and 2021.

Although spending for these services reached multiple neighborhoods, payments were mainly concentrated in a small number of ZIP codes. In 2024, ZIP code 07060 alone accounted for $4,589,780, with the leading ZIP code representing all Medicaid payments tied to National Codes Established for State Medicaid Agencies in North Plainfield that year.

Within the National Codes Established for State Medicaid Agencies group, Medicaid payments were also concentrated among a small subset of billing codes.

Comparing 2024 and 2023, North Plainfield saw Medicaid payments connected to National Codes Established for State Medicaid Agencies increase by 10.7%, outpacing the city’s overall Medicaid claim category growth of 5.9% during the same period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid outlays reached about $871.7 billion in fiscal year 2023, which made up roughly 18% of total U.S. health spending. This was a significant rise from around $613.5 billion in 2019, prior to the COVID-19 pandemic.

This nearly 40% increase over a few years was largely the result of expanded Medicaid enrollment and greater use of services during and after the pandemic.

Recent federal budget measures under the Trump administration have included major proposals to scale back federal Medicaid funding and reshape the program. As an example, the “One Big Beautiful Bill Act,” enacted in 2025, is forecasted to reduce federal Medicaid payments by more than $1 trillion over the next decade and incorporates measures such as work requirements and increased cost-sharing that could decrease coverage and funding for certain beneficiaries. These shifts are set to place more costs with states and restrict the expansion of federal Medicaid dollars, though the program will continue serving tens of millions of Americans.

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.