In 2024, Medicaid providers in Holyoke submitted claims totaling $35,602,799 for services within the National Codes Established for State Medicaid Agencies category, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented an increase of 53.4% compared to 2023, when claims for the same category reached $23,211,508.
Medicaid, a public health insurance program managed at the state level and jointly funded by federal and state governments, serves low-income families and individuals, seniors, children, and people with disabilities. It remains one of the core components of the U.S. health care landscape.
Because Medicaid is financed through taxpayer dollars, fluctuations in local billing patterns illustrate shifts in how communities allocate health care funding.
The “National Codes Established for State Medicaid Agencies” category includes a set of services billed to Medicaid, grouped by care type using standardized HCPCS and CPT codes. For this report, each billing code was linked to a single service group using consistent code prefixes and numeric ranges. This method allows related services to be grouped for analysis, ensuring accuracy in both ranking and accounting across years.
Spending associated with multiple Medicaid service categories increased, but National Codes Established for State Medicaid Agencies accounted for the highest total Medicaid payments in Holyoke in 2024.
Across Massachusetts, National Codes Established for State Medicaid Agencies also had the top ranking by total Medicaid payments in 2024.
During the five years preceding 2024, Medicaid payments tied to the National Codes Established for State Medicaid Agencies category in Holyoke rose by $8,816,571, or 19.8%. Some of the most significant growth occurred in 2020 and 2021, with marked increases year over year.
While Medicaid payments for these services were distributed throughout Holyoke, the majority came from a small number of ZIP codes. In 2024, ZIP code 01040 accounted for $35,602,799 in Medicaid payments under this category. Altogether, this ZIP code represented 100% of Holyoke’s Medicaid payments in the category during the year.
Within this service group, Medicaid spending was centered around a select group of individual billing codes.
Comparatively, Medicaid payment growth tied to National Codes Established for State Medicaid Agencies in Holyoke was 53.4% between 2024 and 2023, whereas all Medicaid claim categories in the city saw a 2.7% increase in the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined state and federal spending on Medicaid reached approximately $871.7 billion in fiscal 2023—about 18% of all national health care expenditures—an increase from around $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This growth amounts to roughly 40% over a span of several years, driven in large part by broader enrollment and increased service use tied to the pandemic period and its aftermath.
Recent federal budget measures during the Trump administration have featured notable proposals to cut federal Medicaid funding and change the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is estimated to reduce federal Medicaid outlays by more than $1 trillion over a decade. The law introduces elements such as work requirements and greater cost-sharing, measures that could lead to diminished coverage and funding for certain recipients. The result is expected to transfer more financial responsibility to states and limit future federal Medicaid funding growth, even as millions continue to depend on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $44,419,370 | 6.4% |
| 2021 | $47,023,337 | 5.9% |
| 2022 | $29,542,948 | -37.2% |
| 2023 | $23,211,507 | -21.4% |
| 2024 | $35,602,799 | 53.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $35,602,799 | 34.3% |
| 2 | Temporary National Codes (Non-Medicare) | $14,240,318 | 13.7% |
| 3 | Medicine Services and Procedures | $12,552,485 | 12.1% |
| 4 | Pathology and Laboratory Procedures | $11,790,231 | 11.4% |
| 5 | Evaluation and Management | $11,108,929 | 10.7% |
| 6 | Alcohol and Drug Abuse Treatment | $7,992,047 | 7.7% |
| 7 | Procedures / Professional Services | $6,141,674 | 5.9% |
| 8 | Dental Services | $1,410,991 | 1.4% |
| 9 | Radiology Procedures | $1,358,759 | 1.3% |
| 10 | Surgery | $846,144 | 0.8% |
| 11 | Drugs Administered Other than Oral Method | $645,470 | 0.6% |
| 12 | Durable Medical Equipment | $25,889 | <0.1% |
| 13 | Hearing Services | $25,001 | <0.1% |
| 14 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $10,989 | <0.1% |
| 15 | Medical And Surgical Supplies | $6,416 | <0.1% |
| 16 | Temporary Codes | $5,850 | <0.1% |
| 17 | Administrative, Miscellaneous and Investigational | $2,643 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $28,754,789 | 10 |
| T2023 | Targeted case mgmt per month | $1,780,474 | 14 |
| T2003 | N-et; encounter/trip | $1,571,372 | 22 |
| T1027 | Family training & counseling | $1,159,730 | 21 |
| T2022 | Case management, per month | $878,101 | 22 |
| T2019 | Habil sup empl waiver 15min | $839,043 | 10 |
| T1015 | Clinic service | $226,172 | 12 |
| T1019 | Personal care ser per 15 min | $219,549 | 15 |
| T1005 | Respite care service 15 min | $84,917 | 10 |
| T1023 | Program intake assessment | $68,507 | 17 |
| T1040 | Comm bh clinic svc per diem | $13,300 | 2 |
| T1020 | Personal care ser per diem | $6,840 | 8 |
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.
