Longmont Medicaid providers billed $21,780,486 in 2024 for services categorized under the National Codes Established for State Medicaid Agencies, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represented a 7.2% rise compared with 2023, when providers submitted $20,322,246 in claims for the same service category.
Medicaid, funded through a partnership between federal and state governments and administered at the state level, serves low-income residents, seniors, children, and people with disabilities, making it among the largest components of the U.S. health care system.
Since Medicaid draws on taxpayer funding, fluctuations in local billing illustrate how health care dollars are distributed in the community.
The “National Codes Established for State Medicaid Agencies” group encompasses Medicaid-billed services identified by type of care, using uniform HCPCS and CPT coding and numeric ranges. For this study, each billing code was matched to one service category using consistent codes, enabling traceable analysis and preventing double counting while maintaining accurate rankings across years.
Though Medicaid payments rose in several categories, the National Codes Established for State Medicaid Agencies category saw the highest overall Medicaid payment total in Longmont in 2024.
This same category also led statewide Medicaid payment totals in Colorado for 2024.
Between 2020 and 2024 in Longmont, Medicaid payments for the National Codes Established for State Medicaid Agencies category rose by $772,473, or 3.4%. Some periods recorded especially notable spending growth, including significant year-over-year increases in both 2023 and 2022.
Payments for care classified in the National Codes Established for State Medicaid Agencies category were distributed citywide, though most were concentrated within a few ZIP codes. For 2024, ZIP codes 80501 and 80504 saw the highest Medicaid payment totals, reporting $21,563,944 and $216,541, respectively, combining for 100% of all Medicaid payments in this category throughout Longmont.
Medicaid funding within this category was further concentrated among a select number of individual billing codes.
To compare, Medicaid payments tied to this category in Longmont increased 7.2% from 2023 to 2024, outpacing the overall increase of 3.4% across all Medicaid claim categories in the city for the same period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures reached approximately $871.7 billion for fiscal year 2023, making up nearly 18% of national health expenses—an increase from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.
This change reflects about 40% overall growth in a short timeframe, primarily due to expanded enrollment numbers and greater utilization during the pandemic and after.
Recent federal budgets passed under the Trump administration feature significant plans to lower federal Medicaid funding and reshape the program. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid support by over $1 trillion over 10 years and implement measures such as work requirements and raised cost-sharing, which could decrease benefits and resources for some recipients. These policies are projected to increase the cost burden on state governments and constrain growth in federal contributions, even with the program’s continued coverage of tens of millions across the nation.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $22,552,959 | -3.6% |
| 2021 | $18,960,866 | -15.9% |
| 2022 | $18,350,566 | -3.2% |
| 2023 | $20,322,245 | 10.7% |
| 2024 | $21,780,485 | 7.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $21,780,485 | 52.1% |
| 2 | Medicine Services and Procedures | $8,036,888 | 19.2% |
| 3 | Evaluation and Management | $4,737,555 | 11.3% |
| 4 | Alcohol and Drug Abuse Treatment | $2,286,921 | 5.5% |
| 5 | Dental Services | $1,717,842 | 4.1% |
| 6 | Vision Services | $1,581,933 | 3.8% |
| 7 | Durable Medical Equipment | $357,285 | 0.9% |
| 8 | Procedures / Professional Services | $268,169 | 0.6% |
| 9 | Surgery | $214,664 | 0.5% |
| 10 | Radiology Procedures | $187,993 | 0.4% |
| 11 | Temporary National Codes (Non-Medicare) | $165,500 | 0.4% |
| 12 | Medical And Surgical Supplies | $156,051 | 0.4% |
| 13 | Pathology and Laboratory Procedures | $141,716 | 0.3% |
| 14 | Ambulance and Other Transport Services and Supplies | $118,869 | 0.3% |
| 15 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $33,100 | 0.1% |
| 16 | Drugs Administered Other than Oral Method | $31,538 | 0.1% |
| 17 | Chemotherapy Drugs | $3,113 | <0.1% |
| 18 | Temporary Codes | $138 | <0.1% |
| 19 | Administrative, Miscellaneous and Investigational | $7 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $15,009,867 | 36 |
| T2021 | Day habil waiver per 15 min | $2,915,183 | 48 |
| T2019 | Habil sup empl waiver 15min | $1,330,923 | 34 |
| T2031 | Assist living waiver/diem | $1,102,389 | 12 |
| T2003 | N-et; encounter/trip | $809,683 | 36 |
| T1019 | Personal care ser per 15 min | $387,124 | 38 |
| T2024 | Serv asmnt/care plan waiver | $225,314 | 12 |
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.
