In 2024, Medicaid providers in Edinburg billed $125,839,888 for services within the Temporary National Codes (Non-Medicare) classification, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a 12.9% rise over 2023, when claims for these services totaled $111,416,236.
Medicaid is a public health insurance initiative administered by states and funded jointly by federal and state governments. It serves low-income people and families, seniors, children, and individuals with disabilities, making up a significant part of the U.S. health care system.
Because taxpayer dollars finance Medicaid, shifts in local billing levels reflect how public health funds are distributed across the community.
The “Temporary National Codes (Non-Medicare)” service group includes a set of Medicaid-billed services defined by type of care, using standardized HCPCS and CPT code groupings. In this review, each billing code was linked to one service category utilizing consistent code prefixes and number ranges. This approach groups similar services while preventing duplicated counts and maintaining accurate rankings over time.
Medicaid expenditures rose in multiple service groups, but Temporary National Codes (Non-Medicare) led Edinburg in total Medicaid payments for 2024.
Statewide across Texas, the Temporary National Codes (Non-Medicare) category also was the largest by total Medicaid payments for the year.
Looking at the five years up to 2024, Medicaid payments for the Temporary National Codes (Non-Medicare) category in Edinburg increased by $79,517,833, or 171.7%. Some years, such as 2021 and 2020, saw pronounced year-over-year growth.
Although spending on Temporary National Codes (Non-Medicare) services was spread citywide, payments were highly concentrated in few ZIP codes. In 2024, ZIP codes with the largest Medicaid payments for this category included 78539 ($95,157,171), 78542 ($19,913,620), and 78541 ($10,769,095). Combined, these 3 ZIP codes accounted for all Medicaid payments in Edinburg tied to this category for the year.
Most Medicaid payments in the Temporary National Codes (Non-Medicare) category were concentrated within a small group of billing codes.
In Edinburg, Medicaid payments for the Temporary National Codes (Non-Medicare) category rose 12.9% from 2023 to 2024, outpacing the 8.4% change for all Medicaid claim categories in the city during the same interval.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached about $871.7 billion for fiscal year 2023, making up about 18% of national health expenditures. This is a substantial rise from $613.5 billion in 2019 before the COVID-19 pandemic.
This increase amounts to about 40% growth in just several years, with much of it driven by expanded enrollment and greater use of health care services around and after the pandemic.
Recent federal budget laws passed during the Trump administration have included major proposals to reduce federal Medicaid funding and change the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is forecast to reduce federal Medicaid spending by over $1 trillion in the coming decade and features measures like work requirements and increased cost-sharing. These changes could reduce funding and coverage for certain beneficiaries. States are expected to face higher costs and more limits on future federal Medicaid growth, even as the program continues to cover tens of millions across the country.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $46,322,055 | 100.9% |
| 2021 | $109,648,396 | 136.7% |
| 2022 | $114,782,335 | 4.7% |
| 2023 | $111,416,236 | -2.9% |
| 2024 | $125,839,887 | 12.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $125,839,887 | 48.5% |
| 2 | Evaluation and Management | $47,689,358 | 18.4% |
| 3 | National Codes Established for State Medicaid Agencies | $25,678,407 | 9.9% |
| 4 | Alcohol and Drug Abuse Treatment | $18,311,732 | 7.1% |
| 5 | Medicine Services and Procedures | $14,274,623 | 5.5% |
| 6 | Pathology and Laboratory Procedures | $12,370,157 | 4.8% |
| 7 | Radiology Procedures | $3,117,719 | 1.2% |
| 8 | Dental Services | $2,785,787 | 1.1% |
| 9 | Surgery | $1,856,399 | 0.7% |
| 10 | Ambulance and Other Transport Services and Supplies | $1,491,404 | 0.6% |
| 11 | Procedures / Professional Services | $1,325,845 | 0.5% |
| 12 | Enteral and Parenteral Therapy | $1,282,765 | 0.5% |
| 13 | Anesthesia | $1,169,041 | 0.5% |
| 14 | Medical And Surgical Supplies | $1,112,079 | 0.4% |
| 15 | Durable Medical Equipment | $380,642 | 0.1% |
| 16 | Vision Services | $210,255 | 0.1% |
| 17 | Coronavirus Diagnostic Panel | $201,663 | 0.1% |
| 18 | Orthotic Procedures and services | $171,236 | 0.1% |
| 19 | Drugs Administered Other than Oral Method | $115,622 | <0.1% |
| 20 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $6,453 | <0.1% |
| 21 | Temporary Codes | $4,720 | <0.1% |
| 22 | Administrative, Miscellaneous and Investigational | $4,352 | <0.1% |
| 23 | Chemotherapy Drugs | $2,017 | <0.1% |
| 24 | Outpatient PPS | $31 | <0.1% |
| 25 | Pathology and Laboratory Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| S5125 | Attendant care service /15m | $118,367,742 | 429 |
| S5101 | Adult day care per half day | $7,020,308 | 196 |
| S5150 | Unskilled respite care /15m | $215,641 | 23 |
| S9110 | Telemonitoring/home per mnth | $132,740 | 23 |
| S0621 | Routine ophthalmological exa | $57,231 | 18 |
| S0620 | Routine ophthalmological exa | $30,552 | 17 |
| S4993 | Contraceptive pills for bc | $8,385 | 5 |
| S0164 | Injection pantroprazole | $5,285 | 4 |
| S9152 | Speech therapy, re-eval | $1,771 | 1 |
| S0119 | Ondansetron 4 mg | $228 | 29 |
| S8301 | Infect control supplies nos | $0 | 1 |
| S9451 | Exercise class | $0 | 24 |
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.
