In 2024, Medicaid providers in Clarksville billed $13,777,402 for services grouped under the National Codes Established for State Medicaid Agencies, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure reflects a 154.7% jump over 2023, when such claims totaled $5,408,450.
Medicaid, a state-operated program with joint federal and state funding, provides health insurance to low-income residents, families, seniors, children, and people with disabilities, constituting a major element of the U.S. health care landscape.
Since Medicaid financing relies on taxpayer contributions, local billing variations indicate how public health funds are distributed at the community level.
The “National Codes Established for State Medicaid Agencies” grouping designates a set of Medicaid-billed services determined by care type, utilizing standardized HCPCS and CPT code classifications. For this evaluation, each code was placed into a single service category according to consistent code prefixes and number ranges, facilitating comparison of related services while preventing double counting and supporting accurate rankings over time.
Spending expanded across several Medicaid categories, but National Codes Established for State Medicaid Agencies accounted for the highest total in Clarksville in 2024.
Statewide in Tennessee, this category also led all Medicaid service groupings by total payments in 2024.
Medicaid payments in Clarksville tied to the National Codes Established for State Medicaid Agencies category saw a net rise of $13,076,006—a growth of 1864.3%—over the five-year span preceding 2024. Certain years, such as 2020 and 2022, saw especially pronounced annual increases.
Payments for these services, although spread across Clarksville, were heavily concentrated in a few ZIP codes. In 2024, ZIP code 37040 saw $8,917,977 in Medicaid payments, 37043 posted $3,254,060, and 37042 registered $1,605,363. Collectively, these 3 ZIP codes made up 100% of the Medicaid spending for this service category in Clarksville during the year.
Within the broader category, a select number of billing codes captured the majority of Clarksville’s Medicaid payments.
Looking at the previous year, payments for the National Codes Established for State Medicaid Agencies in Clarksville increased 154.7% between 2024 and 2023; for comparison, the total spent across all Medicaid claim categories citywide rose 16.9% during the same timeframe.
Data from the Centers for Medicare & Medicaid Services indicate that combined federal and state Medicaid spending reached about $871.7 billion in fiscal year 2023, representing nearly 18% of all U.S. health spending and marking a significant climb from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.
That increase amounts to an approximate 40% rise over several years, attributed mainly to broader enrollment and elevated usage during the pandemic and its aftermath.
Recent budget measures passed during the Trump administration introduced substantial federal Medicaid funding cuts and program restructuring. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid disbursements by over $1 trillion over the next decade. It also adds new requirements, such as work mandates and higher cost-sharing, potentially decreasing both coverage and funding for some program participants. These adjustments may shift greater financial responsibility to states and curb increases in federal Medicaid support, while the program continues to insure tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $701,395 | 327.2% |
| 2021 | $1,657,256 | 136.3% |
| 2022 | $4,652,454 | 180.7% |
| 2023 | $5,408,450 | 16.2% |
| 2024 | $13,777,401 | 154.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $13,777,401 | 39.6% |
| 2 | Evaluation and Management | $8,214,601 | 23.6% |
| 3 | Medicine Services and Procedures | $6,047,989 | 17.4% |
| 4 | Radiology Procedures | $2,083,234 | 6% |
| 5 | Temporary National Codes (Non-Medicare) | $1,155,361 | 3.3% |
| 6 | Ambulance and Other Transport Services and Supplies | $1,040,318 | 3% |
| 7 | Pathology and Laboratory Procedures | $771,584 | 2.2% |
| 8 | Alcohol and Drug Abuse Treatment | $432,150 | 1.2% |
| 9 | Dental Services | $406,358 | 1.2% |
| 10 | Surgery | $362,631 | 1% |
| 11 | Durable Medical Equipment | $196,372 | 0.6% |
| 12 | Medical And Surgical Supplies | $139,851 | 0.4% |
| 13 | Vision Services | $103,779 | 0.3% |
| 14 | Procedures / Professional Services | $51,255 | 0.1% |
| 15 | Drugs Administered Other than Oral Method | $29,122 | 0.1% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $18,337 | 0.1% |
| 17 | Temporary Codes | $2,861 | <0.1% |
| 18 | Outpatient PPS | $0 | <0.1% |
| 18 | Prosthetic Procedures | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2033 | Res, nos waiver per diem | $6,228,721 | 16 |
| T2016 | Habil res waiver per diem | $2,714,430 | 12 |
| T1000 | Private duty/independent nsg | $1,498,482 | 11 |
| T2021 | Day habil waiver per 15 min | $1,357,673 | 16 |
| T1019 | Personal care ser per 15 min | $1,149,001 | 22 |
| T2025 | Waiver service, nos | $775,447 | 11 |
| T2019 | Habil sup empl waiver 15min | $32,283 | 2 |
| T2002 | N-et; per diem | $21,361 | 6 |
Note: HCPCS codes are listed for context in this category. Rankings and totals in this report reflect standardized service groupings, not individual billing codes.
All figures and information for this article are from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Detailed source data is available here.
