In 2024, Knoxville Medicaid providers submitted $41,727,684 in claims for services within the National Codes Established for State Medicaid Agencies category, U.S. Department of Health and Human Services Medicaid Provider Spending database data shows. That total reflects a 143.6% jump from 2023, when $17,127,595 in similar claims were filed.
Medicaid is a joint federal-state program managed by states and funded collectively by federal and state governments. The program serves low-income people, seniors, children, and individuals with disabilities, making it a central part of America’s health care landscape.
Since Medicaid spending is supported by taxpayers, billing changes at the local level reveal how public health care dollars are distributed in an area.
The “National Codes Established for State Medicaid Agencies” category groups Medicaid-billed services according to care type using standard HCPCS and CPT code groupings. For this report, each code was organized into a service category using consistent code prefixes and number ranges, so related services could be tracked together while preventing double counting and maintaining reliable rankings.
Spending growth was seen in several Medicaid service categories, with National Codes Established for State Medicaid Agencies taking the No. 2 spot by total Medicaid payments in Knoxville during 2024.
Across Tennessee, the National Codes Established for State Medicaid Agencies category ranked first in total Medicaid payments in 2024.
From 2019 through 2024, Medicaid payments for the National Codes Established for State Medicaid Agencies category in Knoxville rose by $32,808,833, a 367.9% increase. The pace of growth accelerated in particular years, with significant year-over-year increases noted in 2023 and 2020.
Payments for care tied to the National Codes Established for State Medicaid Agencies in Knoxville were distributed citywide but concentrated within select ZIP codes. In 2024, the top ZIP codes with the highest Medicaid spending in this category were 37912 ($14,961,313), 37917 ($7,064,734), and 37932 ($6,677,144). Together, these ZIP codes represented 68.8% of total citywide Medicaid payments associated with this category for the year.
Within the category, a smaller subset of billing codes accounted for most of the Medicaid payments.
Comparatively, Medicaid spending on the National Codes Established for State Medicaid Agencies category in Knoxville jumped 143.6% from 2023 to 2024. For all Medicaid payment categories in the city, the increase during the same period was 3%.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures stood at about $871.7 billion for fiscal 2023, constituting roughly 18% of national health spending. This marked a sharp rise from around $613.5 billion in 2019, ahead of the COVID-19 pandemic.
This growth amounts to nearly a 40% increase in just a few years, with expanded enrollment and higher usage during and after the pandemic contributing significantly.
Recent federal budget measures under the Trump administration featured major initiatives to curb federal Medicaid funding and restructure provisions. For instance, the “One Big Beautiful Bill Act,” signed in 2025, is set to reduce federal Medicaid spending by over $1 trillion in the coming decade. It also introduces work requirements and higher cost-sharing that could curtail funding and coverage for some enrollees. These adjustments are expected to transfer more cost obligations to states and restrict the pace of federal Medicaid funding, though the program will continue to provide coverage to tens of millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $8,918,851 | 40.2% |
| 2021 | $9,656,274 | 8.3% |
| 2022 | $11,827,063 | 22.5% |
| 2023 | $17,127,594 | 44.8% |
| 2024 | $41,727,683 | 143.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $50,187,473 | 23% |
| 2 | National Codes Established for State Medicaid Agencies | $41,727,683 | 19.1% |
| 3 | Medicine Services and Procedures | $36,689,090 | 16.8% |
| 4 | Temporary National Codes (Non-Medicare) | $26,907,822 | 12.3% |
| 5 | Alcohol and Drug Abuse Treatment | $15,572,639 | 7.1% |
| 6 | Radiology Procedures | $12,638,440 | 5.8% |
| 7 | Pathology and Laboratory Procedures | $8,980,158 | 4.1% |
| 8 | Surgery | $7,789,135 | 3.6% |
| 9 | Ambulance and Other Transport Services and Supplies | $5,592,368 | 2.6% |
| 10 | Procedures / Professional Services | $2,902,181 | 1.3% |
| 11 | Enteral and Parenteral Therapy | $2,429,564 | 1.1% |
| 12 | Dental Services | $1,435,500 | 0.7% |
| 13 | Durable Medical Equipment | $1,361,011 | 0.6% |
| 14 | Anesthesia | $1,244,243 | 0.6% |
| 15 | Drugs Administered Other than Oral Method | $1,013,708 | 0.5% |
| 16 | Medical And Surgical Supplies | $525,870 | 0.2% |
| 17 | Administrative, Miscellaneous and Investigational | $494,754 | 0.2% |
| 18 | Vision Services | $400,769 | 0.2% |
| 19 | Orthotic Procedures and services | $330,874 | 0.2% |
| 20 | Temporary Codes | $214,392 | 0.1% |
| 21 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $133,634 | 0.1% |
| 22 | Chemotherapy Drugs | $33,207 | <0.1% |
| 23 | Outpatient PPS | $7,969 | <0.1% |
| 24 | Prosthetic Procedures | $5,139 | <0.1% |
| 25 | Pathology and Laboratory Services | $2,101 | <0.1% |
| 26 | Other Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2033 | Res, nos waiver per diem | $15,389,022 | 47 |
| T1000 | Private duty/independent nsg | $6,381,491 | 12 |
| T2048 | Bh ltc res r&b, per diem | $5,452,002 | 21 |
| T1019 | Personal care ser per 15 min | $4,258,703 | 85 |
| T2021 | Day habil waiver per 15 min | $2,909,057 | 45 |
| T2016 | Habil res waiver per diem | $2,192,485 | 4 |
| T1041 | Comm bh clinic svc per month | $1,076,965 | 10 |
| T2046 | Hospice long term care, r&b | $1,030,593 | 10 |
| T2030 | Assist living waiver/month | $915,479 | 33 |
| T2022 | Case management, per month | $889,389 | 6 |
| T2025 | Waiver service, nos | $730,968 | 5 |
| T2042 | Hospice routine home care | $219,514 | 5 |
| T2012 | Habil ed waiver, per diem | $198,886 | 4 |
| T2019 | Habil sup empl waiver 15min | $82,765 | 4 |
| T1013 | Sign lang/oral interpreter | $360 | 2 |
| T2007 | Non-emer transport wait time | $0 | 6 |
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.