Sherman Medicaid providers billed $192,254,230 in 2024 for services under the National Codes Established for State Medicaid Agencies category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 10% increase from 2023, when providers reported $174,812,899 in claims for these services.
Medicaid provides public health insurance through a partnership between federal and state governments, covering low-income individuals and families, seniors, children, and people with disabilities. This makes Medicaid one of the nation’s largest health care programs, with funding shared between both levels of government.
Since Medicaid is paid for by taxpayers, shifts in billing on a local scale offer insights into the allocation of public health care resources within a community.
The National Codes Established for State Medicaid Agencies category groups services defined by type of care, utilizing standardized HCPCS and CPT code classifications. For this analysis, each billing code is tied to a specific service category using code prefixes and numeric ranges to keep related services together while avoiding double counting and ensuring accuracy in year-over-year rankings.
While Medicaid spending grew in various service categories, the National Codes Established for State Medicaid Agencies group took the top spot among Medicaid payments in Sherman for 2024.
At the state level in Texas, National Codes Established for State Medicaid Agencies ranked second by Medicaid payment amounts in 2024.
Between 2019 and 2024, National Codes Established for State Medicaid Agencies payments in Sherman climbed by $170,072,743, a 766.7% rise. Growth in expenditures accelerated during some intervals, with significant yearly jumps in 2020 and 2021.
Spending on services grouped under National Codes Established for State Medicaid Agencies was spread across Sherman but concentrated within a few ZIP codes. In 2024, Medicaid payments in the 75090 ZIP code totaled $192,073,440 and in 75092 reached $180,789. These 2 ZIP codes combined covered 100% of all Medicaid payments in this category for the year in Sherman.
Payments within this service category were also concentrated within a relatively small range of billing codes.
Comparing the years 2024 and 2023, payments tied to National Codes Established for State Medicaid Agencies in Sherman increased by 10%. In the same period, Medicaid payments across all categories citywide moved up by 8.2%.
Centers for Medicare & Medicaid Services data shows that federal and state Medicaid expenditures reached about $871.7 billion in fiscal 2023, which represented approximately 18% of total U.S. health spending, up sharply from $613.5 billion in 2019, pre-pandemic.
The surge corresponds to approximately 40% growth within a few years, fueled primarily by greater enrollment and utilization associated with the COVID-19 pandemic period and its aftermath.
Under recent federal budget laws enacted during the Trump administration, significant changes have been proposed to reduce federal Medicaid funding and overhaul the program. The “One Big Beautiful Bill Act,” which became law in 2025, is expected to cut more than $1 trillion from federal Medicaid spending over 10 years and adds policies such as work requirements and added cost-sharing, which could lower coverage and funding for some recipients and raise states’ funding burden, even as Medicaid remains a vital resource to tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $22,181,487 | 1887.5% |
| 2021 | $104,468,941 | 371% |
| 2022 | $126,166,525 | 20.8% |
| 2023 | $174,812,898 | 38.6% |
| 2024 | $192,254,229 | 10% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $192,254,229 | 84.1% |
| 2 | Temporary National Codes (Non-Medicare) | $18,503,145 | 8.1% |
| 3 | Medicine Services and Procedures | $9,928,364 | 4.3% |
| 4 | Evaluation and Management | $4,742,153 | 2.1% |
| 5 | Alcohol and Drug Abuse Treatment | $1,205,819 | 0.5% |
| 6 | Dental Services | $908,117 | 0.4% |
| 7 | Pathology and Laboratory Procedures | $578,298 | 0.3% |
| 8 | Temporary Codes | $194,358 | 0.1% |
| 9 | Ambulance and Other Transport Services and Supplies | $92,886 | <0.1% |
| 10 | Vision Services | $62,963 | <0.1% |
| 11 | Durable Medical Equipment | $56,345 | <0.1% |
| 12 | Radiology Procedures | $53,952 | <0.1% |
| 13 | Surgery | $35,644 | <0.1% |
| 14 | Anesthesia | $10,473 | <0.1% |
| 15 | Medical And Surgical Supplies | $4,719 | <0.1% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $2,122 | <0.1% |
| 17 | Procedures / Professional Services | $983 | <0.1% |
| 18 | Diagnostic Radiology Services | $690 | <0.1% |
| 19 | Drugs Administered Other than Oral Method | $48 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1000 | Private duty/independent nsg | $187,545,766 | 24 |
| T1005 | Respite care service 15 min | $2,125,492 | 16 |
| T2046 | Hospice long term care, r&b | $1,457,907 | 23 |
| T1019 | Personal care ser per 15 min | $900,571 | 49 |
| T1017 | Targeted case management | $180,789 | 12 |
| T2003 | N-et; encounter/trip | $43,702 | 10 |
Note: HCPCS codes are listed for reference within this category. All category totals and ranking in this piece reference standardized service groupings rather than individual billing entries.
Figures used in this article were sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Find the source data here.
