Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows that Fort Collins Medicaid providers submitted $25,357,054 in claims for services grouped within the National Codes Established for State Medicaid Agencies category in 2024. This amount represented a 9.4% increase compared to 2023, when claims in this category totaled $23,170,097.
Medicaid, a public health insurance initiative operated by the states with joint federal and state funding, covers low-income people, families, older adults, children and individuals with disabilities. It remains one of the nation’s largest health care programs. Learn more at the Commonwealth Fund.
Fluctuations in local Medicaid billing levels, which are funded by taxpayers, highlight how communities allocate public health care resources.
The “National Codes Established for State Medicaid Agencies” category refers to a collection of Medicaid-billed services organized by specific care types, using standard HCPCS and CPT code groupings. This analysis assigned billing codes to a single service category through consistent code prefixes and numeric ranges, ensuring related care could be tracked together without duplication and that historical rankings remained accurate.
Among Medicaid service categories in Fort Collins, National Codes Established for State Medicaid Agencies was the highest in total payments during 2024.
Statewide, this service category also held the top spot for Medicaid payments in 2024 across Colorado.
Over the five-year period prior to 2024, Medicaid payments linked to the National Codes Established for State Medicaid Agencies category in Fort Collins climbed by $7,966,213, or 45.8%. Notable spending growth occurred during certain years, with especially strong increases seen in 2022 and 2023.
While payments for this category were distributed throughout Fort Collins, spending was heavily concentrated within a small set of ZIP codes. In 2024, Medicaid claims for the National Codes Established for State Medicaid Agencies category reached $15,589,113 in 80525, $5,246,020 in 80524 and $4,070,784 in 80526. These three areas combined represented 98.2% of all Medicaid payments in the category for the city that year.
Within the National Codes Established for State Medicaid Agencies category, a limited group of individual billing codes accounted for the majority of local Medicaid payments.
Between 2023 and 2024, Medicaid payments for the National Codes Established for State Medicaid Agencies category in Fort Collins rose by 9.4%, outpacing the overall 5.6% growth observed across all Medicaid categories in the city for the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending was approximately $871.7 billion in fiscal year 2023, which was about 18% of all U.S. health care expenditures. By comparison, spending in 2019 before the COVID-19 pandemic was about $613.5 billion.
This change marks an increase of nearly 40% over just a few years, fueled largely by higher enrollment and greater service use during and after the pandemic.
Recent federal budget legislation from the Trump administration has featured major proposals to shrink federal Medicaid funding and reorganize the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next 10 years, while also introducing work requirements and increased cost-sharing that could affect beneficiary coverage and funding. These policy changes are anticipated to shift more financial responsibility to states and curb the growth of federal Medicaid support, even as the program continues to provide services for tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $17,390,840 | -2.4% |
| 2021 | $17,451,964 | 0.4% |
| 2022 | $21,234,264 | 21.7% |
| 2023 | $23,170,096 | 9.1% |
| 2024 | $25,357,054 | 9.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $25,357,054 | 34.3% |
| 2 | Evaluation and Management | $12,726,667 | 17.2% |
| 3 | Medicine Services and Procedures | $10,909,403 | 14.8% |
| 4 | Alcohol and Drug Abuse Treatment | $7,916,534 | 10.7% |
| 5 | Procedures / Professional Services | $7,182,961 | 9.7% |
| 6 | Dental Services | $2,060,849 | 2.8% |
| 7 | Temporary National Codes (Non-Medicare) | $1,698,583 | 2.3% |
| 8 | Vision Services | $1,109,854 | 1.5% |
| 9 | Radiology Procedures | $1,056,105 | 1.4% |
| 10 | Ambulance and Other Transport Services and Supplies | $964,873 | 1.3% |
| 11 | Pathology and Laboratory Procedures | $732,144 | 1% |
| 12 | Surgery | $730,243 | 1% |
| 13 | Durable Medical Equipment | $503,737 | 0.7% |
| 14 | Medical And Surgical Supplies | $377,180 | 0.5% |
| 15 | Drugs Administered Other than Oral Method | $305,495 | 0.4% |
| 16 | Anesthesia | $208,837 | 0.3% |
| 17 | Orthotic Procedures and services | $49,006 | 0.1% |
| 18 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $16,275 | <0.1% |
| 19 | Administrative, Miscellaneous and Investigational | $8,207 | <0.1% |
| 20 | Chemotherapy Drugs | $5,903 | <0.1% |
| 21 | Temporary Codes | $17 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $13,414,883 | 57 |
| T2021 | Day habil waiver per 15 min | $4,704,884 | 104 |
| T2023 | Targeted case mgmt per month | $3,091,272 | 10 |
| T2031 | Assist living waiver/diem | $1,402,899 | 12 |
| T2003 | N-et; encounter/trip | $867,706 | 71 |
| T1019 | Personal care ser per 15 min | $630,553 | 30 |
| T2024 | Serv asmnt/care plan waiver | $557,872 | 10 |
| T1017 | Targeted case management | $443,430 | 26 |
| T2019 | Habil sup empl waiver 15min | $136,443 | 9 |
| T2035 | Utility services waiver | $38,916 | 5 |
| T2028 | Special supply, nos waiver | $31,902 | 10 |
| T1016 | Case management | $20,715 | 6 |
| T4527 | Adult size pull-on lg | $11,117 | 6 |
| T4535 | Disposable liner/shield/pad | $2,297 | 4 |
| T4526 | Adult size pull-on med | $2,158 | 2 |
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.
