Providers in Dover billed $59,262,471 in 2024 for Medicaid services falling under the National Codes Established for State Medicaid Agencies, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount was a 14% rise from 2023, when $51,990,347 in claims were filed for the same service types.
Medicaid, administered by states and funded by both federal and state governments, covers health insurance for low-income individuals and families, seniors, children and people with disabilities. It remains one of the largest segments of the U.S. health care system.
Because taxpayer dollars fund Medicaid payments, fluctuations in local billing levels reveal how health care funds are distributed within communities.
The “National Codes Established for State Medicaid Agencies” category encompasses a range of Medicaid services defined by the kind of care provided, based on standard groupings of HCPCS and CPT codes. For this study, each billing code was matched to a specific service group using uniform code prefixes and number bands, enabling related offerings to be analyzed as one while ensuring accuracy in ranking and avoiding any double counting.
Payment growth for Medicaid was observed in a number of categories, and the National Codes Established for State Medicaid Agencies category led Dover in total Medicaid payments for 2024.
Statewide, the National Codes Established for State Medicaid Agencies category held the top spot by dollars paid through Medicaid in 2024 throughout New Hampshire.
From five years before 2024, Dover saw an increase of $21,511,635, or 57%, in Medicaid payments connected to this category. This rise accelerated at points, with standout growth occurring year over year, particularly in 2023 and 2021.
Although spending for these services spanned Dover, payments primarily came from a small number of ZIP codes. Most notably, the ZIP code 03820 contributed $59,262,471, amounting to 100% of Medicaid payments under this service classification in the city for 2024.
For this service category, payments also clustered around several specific billing codes.
Comparing figures, Medicaid dollars tied to the National Codes Established for State Medicaid Agencies in Dover increased by 14% between 2024 and 2023, while overall Medicaid claim payments in the city rose 8.7% over the same time frame.
The Centers for Medicare & Medicaid Services report that combined federal and state Medicaid expenditures reached about $871.7 billion in fiscal year 2023. This figure made up roughly 18% of all U.S. health spending and marked a notable rise from around $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This escalation represents near 40% growth in a few years, mainly linked to higher enrollment and increased utilization related to and following the pandemic.
Recent federal budget law under the Trump administration introduced several major proposals for reduced federal Medicaid funding and changes to the system. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to reduce federal Medicaid spending by more than $1 trillion over 10 years, establishing changes such as work requirements and added cost-sharing that may decrease access and funding for some enrollees. States are expected to bear more responsibility for costs under these reforms, and growth in federal financial support may be restrained, even as the program serves tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $37,750,836 | -0.4% |
| 2021 | $42,144,290 | 11.6% |
| 2022 | $45,209,517 | 7.3% |
| 2023 | $51,990,346 | 15% |
| 2024 | $59,262,471 | 14% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $59,262,471 | 59.3% |
| 2 | Temporary National Codes (Non-Medicare) | $29,145,226 | 29.2% |
| 3 | Alcohol and Drug Abuse Treatment | $6,397,466 | 6.4% |
| 4 | Evaluation and Management | $2,330,172 | 2.3% |
| 5 | Medicine Services and Procedures | $1,563,730 | 1.6% |
| 6 | Procedures / Professional Services | $609,443 | 0.6% |
| 7 | Ambulance and Other Transport Services and Supplies | $191,046 | 0.2% |
| 8 | Pathology and Laboratory Procedures | $172,914 | 0.2% |
| 9 | Radiology Procedures | $147,324 | 0.1% |
| 10 | Dental Services | $34,727 | <0.1% |
| 11 | Drugs Administered Other than Oral Method | $11,943 | <0.1% |
| 12 | Vision Services | $10,888 | <0.1% |
| 13 | Coronavirus Diagnostic Panel | $8,028 | <0.1% |
| 14 | Surgery | $5,544 | <0.1% |
| 15 | Temporary Codes | $3,818 | <0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1020 | Personal care ser per diem | $22,647,878 | 24 |
| T2021 | Day habil waiver per 15 min | $16,871,624 | 47 |
| T2033 | Res, nos waiver per diem | $6,149,448 | 12 |
| T2015 | Habil prevoc waiver per hr | $3,938,258 | 9 |
| T2017 | Habil res waiver 15 min | $3,144,916 | 25 |
| T1005 | Respite care service 15 min | $2,190,073 | 24 |
| T2025 | Waiver service, nos | $1,281,719 | 22 |
| T2022 | Case management, per month | $993,711 | 12 |
| T1024 | Team evaluation & management | $670,349 | 12 |
| T2023 | Targeted case mgmt per month | $551,252 | 24 |
| T2019 | Habil sup empl waiver 15min | $471,270 | 22 |
| T1016 | Case management | $342,758 | 12 |
| T2035 | Utility services waiver | $9,211 | 11 |
Note: HCPCS codes are provided to contextualize the group. All totals and ranks in this story rely on uniform service-based groupings, not specific codes.
Details for this report come from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original dataset is available here.
