In 2024, Medicaid providers in Walterboro recorded $7,309,019 in billing for services within 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 represented a 1% uptick from 2023, when $7,240,214 in claims were submitted for these services.
Medicaid, which states run and jointly fund with the federal government, covers low-income individuals, families, seniors, children and people with disabilities, making it a major part of the national health care system. More background can be found here.
Changes in local Medicaid billing volumes highlight how community public health resources are distributed, as taxpayer dollars support the program.
The “National Codes Established for State Medicaid Agencies” designation applies to Medicaid-billed services defined by care type, organized with specific HCPCS and CPT code ranges. In compiling this report, each billing code was assigned to a single category using standardized prefixes and ranges to group related care, ensuring accurate comparisons and preventing overlap.
Spending amounts across service groups rose, but National Codes Established for State Medicaid Agencies led all other Medicaid categories in Walterboro for total 2024 payments.
Statewide in South Carolina, National Codes Established for State Medicaid Agencies was also the leading Medicaid category by payment total for the year.
Between 2019 and 2024, Walterboro’s Medicaid payments for the National Codes Established for State Medicaid Agencies group jumped by $5,766,352, marking a 373.8% increase. Notable growth occurred during specific years, with significant year-over-year gains in 2022 and 2023.
Medicaid payments in this category were made throughout Walterboro, but the highest concentrations were found in a few ZIP codes. ZIP code 29488 accounted for $7,309,018 of these Medicaid dollars in 2024, representing 100% of all related payments in the city that year.
Payments within this category were also focused among a small set of billing codes.
Compared to other Medicaid service categories in Walterboro, payments for the National Codes Established for State Medicaid Agencies group grew 1% from 2023 to 2024, while all Medicaid claims collectively increased 9.9% in the city during this period.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023, about 18% of overall U.S. health spending—a sharp increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This climb equates to roughly 40% growth over a few years, attributed mainly to higher enrollment and greater health care use during and after the pandemic.
Congressional budget actions under the Trump administration included notable efforts to cut federal Medicaid funds and alter the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to decrease federal Medicaid outlays by more than $1 trillion over 10 years. It introduces work requirements and expanded cost sharing, which could reduce funding and beneficiary coverage, shifting additional expenses to states.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,542,667 | -18.3% |
| 2021 | $1,798,079 | 16.6% |
| 2022 | $5,799,349 | 222.5% |
| 2023 | $7,240,213 | 24.8% |
| 2024 | $7,309,018 | 1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $7,309,018 | 66.4% |
| 2 | Evaluation and Management | $1,161,125 | 10.5% |
| 3 | Medicine Services and Procedures | $665,624 | 6% |
| 4 | Pathology and Laboratory Procedures | $523,005 | 4.7% |
| 5 | Alcohol and Drug Abuse Treatment | $414,855 | 3.8% |
| 6 | Ambulance and Other Transport Services and Supplies | $177,159 | 1.6% |
| 7 | Radiology Procedures | $174,705 | 1.6% |
| 8 | Surgery | $162,366 | 1.5% |
| 9 | Durable Medical Equipment | $132,215 | 1.2% |
| 10 | Procedures / Professional Services | $102,357 | 0.9% |
| 11 | Dental Services | $88,189 | 0.8% |
| 12 | Medical And Surgical Supplies | $38,327 | 0.3% |
| 13 | Enteral and Parenteral Therapy | $19,710 | 0.2% |
| 14 | Temporary National Codes (Non-Medicare) | $19,354 | 0.2% |
| 15 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $8,285 | 0.1% |
| 16 | Drugs Administered Other than Oral Method | $8,175 | 0.1% |
| 17 | Vision Services | $7,244 | 0.1% |
| 18 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 18 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T2016 | Habil res waiver per diem | $5,131,218 | 12 |
| T1015 | Clinic service | $1,326,044 | 116 |
| T2020 | Day habil waiver per diem | $721,879 | 12 |
| T1016 | Case management | $63,768 | 12 |
| T1502 | Medication admin visit | $31,904 | 8 |
| T1027 | Family training & counseling | $20,638 | 7 |
| T1030 | Rn home care per diem | $11,739 | 6 |
| T5999 | Supply, nos | $1,280 | 12 |
| T1002 | Rn services up to 15 minutes | $296 | 2 |
| T1003 | Lpn/lvn services up to 15min | $248 | 2 |
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.