In 2024, Hayesville Medicaid providers submitted $764,356 in claims for services within the National Codes Established for State Medicaid Agencies category, based on figures reported in the U.S. Department of Health and Human Services Medicaid Provider Spending database. That represented a 41.1% rise from 2023, when claims for the same category reached $541,849.
Medicaid operates as a state-administered public health insurance program, jointly financed by federal and state governments. Designed to provide coverage for low-income residents—including families, the elderly, children, and individuals with disabilities—the program makes up a large segment of the U.S. health care framework.
Fluctuations in Medicaid reimbursement levels at the local level mirror the way taxpayer funds are used for health care services in a community.
The “National Codes Established for State Medicaid Agencies” category groups Medicaid-billed services by type of care, determined by a set of standardized HCPCS and CPT code groupings. Each billing code in this analysis was matched to a single service category using uniform code prefixes and number ranges to organize similar services, prevent double counting, and enable accurate year-to-year comparisons.
Medicaid expenditures increased in multiple service areas, with the National Codes Established for State Medicaid Agencies category ranking second by total Medicaid payments in Hayesville during 2024.
Across North Carolina, the National Codes Established for State Medicaid Agencies was the leading category statewide for total Medicaid payments in 2024.
Between 2019 and 2024, Medicaid payments for this category in Hayesville rose $313,567, an increase of 69.6%. Certain years in this period experienced sharper gains, particularly in 2023 and 2020.
Although these Medicaid payments touched various neighborhoods, they were primarily concentrated in few ZIP codes in Hayesville. In 2024, ZIP code 28904 alone accounted for $764,355 of total Medicaid spending for this category. As a result, this ZIP code represented 100% of such payments locally that year.
Within the National Codes Established for State Medicaid Agencies category, a select group of billing codes drew most of the Medicaid reimbursement activity.
Comparing category growth year to year, Medicaid payments in Hayesville for the National Codes Established for State Medicaid Agencies category increased 41.1% from 2023 to 2024, while the overall rise across all Medicaid-claimed service categories in the city was 10.4% during the same span.
The Centers for Medicare & Medicaid Services reported that federal and state Medicaid spending reached about $871.7 billion for fiscal year 2023, comprising around 18% of the nation’s health expenditures. That figure surged compared with $613.5 billion during 2019, prior to the COVID-19 pandemic.
This amounted to a roughly 40% increase within several years, largely attributed to both rising enrollment and increased utilization during the pandemic period.
Recent Congressional budget bills under the Trump administration have proposed large cutbacks to Medicaid and suggested long-term structural changes. Notably, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to decrease federal Medicaid spending by over $1 trillion over ten years and to introduce new measures such as work requirements and higher cost sharing, potentially limiting coverage and federal funding for some program participants. These developments may shift a greater share of Medicaid costs to the states and restrict federal program expansion, though Medicaid remains a critical health safety net for millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $450,789 | 102.1% |
| 2021 | $287,666 | -36.2% |
| 2022 | $215,177 | -25.2% |
| 2023 | $541,848 | 151.8% |
| 2024 | $764,355 | 41.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $983,194 | 32.4% |
| 2 | National Codes Established for State Medicaid Agencies | $764,355 | 25.2% |
| 3 | Medicine Services and Procedures | $667,629 | 22% |
| 4 | Evaluation and Management | $455,036 | 15% |
| 5 | Dental Services | $109,179 | 3.6% |
| 6 | Ambulance and Other Transport Services and Supplies | $42,300 | 1.4% |
| 7 | Pathology and Laboratory Procedures | $12,019 | 0.4% |
| 8 | Surgery | $98 | <0.1% |
| 9 | Procedures / Professional Services | $9 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $697,629 | 63 |
| T2041 | Support broker waiver/15 min | $39,006 | 5 |
| T1016 | Case management | $27,720 | 5 |
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.