Records show that Medicaid providers in Kissimmee billed $16,017,702 for services classified under the National Codes Established for State Medicaid Agencies category in 2024, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a 4.6% rise from 2023, when providers reported $15,314,318 in claims for similar services.
Medicaid operates as a state-administered public health insurance program with joint funding from federal and state governments. It covers eligible low-income groups including families, seniors, children and people with disabilities, making it a major component of U.S. health care.
Because Medicaid payments utilize taxpayer funds, local fluctuations in billing volumes reflect how public health resources are distributed within a community.
The “National Codes Established for State Medicaid Agencies” grouping includes a set of services billed to Medicaid, described by the type of care and based on standardized HCPCS and CPT codes. For this reporting, billing codes were matched to one service category through established code prefixes and number ranges, supporting analysis of related services, reducing duplicate counts, and preserving ranking accuracy over time.
Spending for Medicaid increased across several service categories, with National Codes Established for State Medicaid Agencies obtaining the No. 2 spot in Kissimmee for total Medicaid payments in 2024.
Statewide in Florida, the National Codes Established for State Medicaid Agencies category also ranked second in total Medicaid payments for 2024.
From 2019 through 2024, Kissimmee Medicaid payments tied to the National Codes Established for State Medicaid Agencies category rose by $5,903,324, or 58.4%. The pace of spending growth varied, with significant increases in 2023 and 2020.
Although the city’s spending for these services was spread across Kissimmee, most payments came from only a few ZIP codes. In 2024, the highest Medicaid payments within this category were reported in ZIP code 34741 ($11,142,044), followed by 34744 ($3,559,214), and 34759 ($1,316,443). Together, these top 3 ZIP codes represented all Medicaid payments tied to this service category in Kissimmee for the year.
Within this category, Medicaid spending was largely concentrated on a select set of billing codes.
When comparing growth, Medicaid payments linked to the National Codes Established for State Medicaid Agencies category in Kissimmee went up 4.6% from 2023 to 2024, while overall Medicaid claim categories in the city saw a 12.1% increase over the same period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached an estimated $871.7 billion in fiscal 2023, comprising about 18% of national health expenditures. That total jumped markedly from around $613.5 billion in 2019, prior to the COVID-19 pandemic.
This rise equates to approximately 40% growth over several years, mainly due to expanded enrollment and increased utilization during and after the pandemic period.
Recent federal budget packages under the Trump administration introduced major changes intended to reduce federal Medicaid funding and alter the program’s structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to cut more than $1 trillion from federal Medicaid spending in the next decade and imposed policies like work requirements and higher cost-sharing, potentially decreasing coverage and funding for certain beneficiaries. These shifts are projected to increase state-level costs and restrict the growth of federal Medicaid contributions, though the program continues serving tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $10,114,377 | 9.8% |
| 2021 | $9,682,703 | -4.3% |
| 2022 | $9,490,233 | -2% |
| 2023 | $15,314,317 | 61.4% |
| 2024 | $16,017,702 | 4.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $19,050,222 | 25.9% |
| 2 | National Codes Established for State Medicaid Agencies | $16,017,702 | 21.7% |
| 3 | Temporary National Codes (Non-Medicare) | $15,067,831 | 20.4% |
| 4 | Alcohol and Drug Abuse Treatment | $10,093,623 | 13.7% |
| 5 | Evaluation and Management | $9,745,678 | 13.2% |
| 6 | Ambulance and Other Transport Services and Supplies | $758,677 | 1% |
| 7 | Durable Medical Equipment | $730,992 | 1% |
| 8 | Dental Services | $500,772 | 0.7% |
| 9 | Enteral and Parenteral Therapy | $436,293 | 0.6% |
| 10 | Pathology and Laboratory Procedures | $317,367 | 0.4% |
| 11 | Radiology Procedures | $299,228 | 0.4% |
| 12 | Medical And Surgical Supplies | $279,628 | 0.4% |
| 13 | Surgery | $169,730 | 0.2% |
| 14 | Drugs Administered Other than Oral Method | $58,420 | 0.1% |
| 15 | Administrative, Miscellaneous and Investigational | $41,115 | 0.1% |
| 16 | Procedures / Professional Services | $37,922 | 0.1% |
| 17 | Coronavirus Diagnostic Panel | $28,642 | <0.1% |
| 18 | Anesthesia | $14,007 | <0.1% |
| 19 | Prosthetic Procedures | $11,310 | <0.1% |
| 20 | Temporary Codes | $10,296 | <0.1% |
| 21 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $6,469 | <0.1% |
| 22 | Vision Services | $5,528 | <0.1% |
| 23 | Orthotic Procedures and services | $586 | <0.1% |
| 24 | Chemotherapy Drugs | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1025 | Ped compr care pkg, per diem | $4,873,105 | 55 |
| T1017 | Targeted case management | $3,605,756 | 117 |
| T1004 | Nsg aide service up to 15min | $2,742,827 | 54 |
| T1019 | Personal care ser per 15 min | $2,503,698 | 42 |
| T2030 | Assist living waiver/month | $1,112,139 | 23 |
| T1015 | Clinic service | $778,637 | 213 |
| T1027 | Family training & counseling | $103,976 | 49 |
| T4534 | Youth size pull-on | $102,180 | 12 |
| T4522 | Adult size brief/diaper med | $35,856 | 11 |
| T4526 | Adult size pull-on med | $29,722 | 10 |
| T4530 | Ped size brief/diaper lg | $27,270 | 12 |
| T4532 | Ped size pull-on lg | $26,214 | 11 |
| T4527 | Adult size pull-on lg | $24,777 | 10 |
| T4525 | Adult size pull-on sm | $17,342 | 9 |
| T1007 | Treatment plan development | $17,212 | 12 |
| T4521 | Adult size brief/diaper sm | $13,580 | 9 |
| T1003 | Lpn/lvn services up to 15min | $1,759 | 5 |
| T4523 | Adult size brief/diaper lg | $1,643 | 1 |
| T1029 | Dwelling lead investigation | $0 | 1 |
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.
