In 2024, providers in Framingham billed $61,986,719 to Medicaid for services in the Temporary National Codes (Non-Medicare) category, based on U.S. Department of Health and Human Services Medicaid Provider Spending data. This was a 13.7% increase over 2023, when $54,509,064 in claims were submitted for this service category.
Medicaid, a state-administered program with joint federal and state funding, provides health insurance to low-income people, families, seniors, children and those with disabilities. As one of the nation’s largest health care programs, it covers a significant portion of the U.S. population.
Because Medicaid’s funding comes from public sources, fluctuations in local billing reveal how taxpayer dollars are distributed within the community’s health system.
The “Temporary National Codes (Non-Medicare)” category includes a range of Medicaid services identified by the type of care, using standardized HCPCS and CPT code sets. This analysis assigned each code to only one service group by code prefix and number, grouping related care for comparison while avoiding duplicate counts and maintaining consistency for trend rankings.
Temporary National Codes (Non-Medicare) accounted for the largest share of Medicaid payments among all service categories in Framingham in 2024.
Statewide, this category ranked second by total Medicaid payments in Massachusetts for 2024.
From 2019 through 2024, Medicaid payments for this category in Framingham rose by $34,899,209, or 128.8%. Growth was especially pronounced in certain years, notably in 2021 and 2022, which saw sizable annual increases.
While care in this category was delivered across Framingham, payments were primarily concentrated within a few ZIP codes. In 2024, ZIP code 01701 saw $52,746,951 in payments, and ZIP code 01702 accounted for $9,239,766. Combined, these two ZIP codes made up 100% of Medicaid payments for this service category citywide during the year.
Spending in the Temporary National Codes (Non-Medicare) category was also focused on a limited selection of billing codes.
Comparatively, the 13.7% jump in Medicaid payments for this category from 2023 to 2024 was slightly below the 17.9% increase across all Medicaid claim categories in the city during the same period.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023, or around 18% of all national health spending. That is up sharply from about $613.5 billion in 2019, before the onset of COVID-19.
This increase amounts to about 40% growth in just a few years, mostly due to higher enrollment and greater service use during and after the pandemic period.
Recent federal budget measures signed under the Trump administration contained notable efforts to reduce federal Medicaid funding and reshape the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to lower federal Medicaid spending by more than $1 trillion over the next 10 years. The law introduces elements such as work requirements and higher cost-sharing, which could limit coverage and decrease funding for some recipients. As a result, states are likely to shoulder a greater portion of Medicaid costs, even as enrollment remains high.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $27,087,510 | 11.9% |
| 2021 | $38,682,854 | 42.8% |
| 2022 | $46,306,246 | 19.7% |
| 2023 | $54,509,063 | 17.7% |
| 2024 | $61,986,718 | 13.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $61,986,718 | 41.5% |
| 2 | National Codes Established for State Medicaid Agencies | $48,458,016 | 32.5% |
| 3 | Alcohol and Drug Abuse Treatment | $14,917,383 | 1<0.1% |
| 4 | Evaluation and Management | $10,561,527 | 7.1% |
| 5 | Medicine Services and Procedures | $4,928,921 | 3.3% |
| 6 | Pathology and Laboratory Procedures | $4,490,177 | 3% |
| 7 | Dental Services | $1,972,828 | 1.3% |
| 8 | Radiology Procedures | $777,226 | 0.5% |
| 9 | Surgery | $605,389 | 0.4% |
| 10 | Procedures / Professional Services | $349,694 | 0.2% |
| 11 | Hearing Services | $186,560 | 0.1% |
| 12 | Drugs Administered Other than Oral Method | $17,389 | <0.1% |
| 13 | Administrative, Miscellaneous and Investigational | $5,631 | <0.1% |
| 14 | Coronavirus Diagnostic Panel | $205 | <0.1% |
| 15 | Temporary Codes | $6 | <0.1% |
| 16 | Medical And Surgical Supplies | $0 | <0.1% |
| 16 | Outpatient PPS | $0 | <0.1% |
| 16 | Vision Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| S5140 | Adult foster care per diem | $47,512,420 | 47 |
| S5102 | Adult day care per diem | $8,975,837 | 32 |
| S5100 | Adult daycare services 15min | $3,639,073 | 20 |
| S5130 | Homaker service nos per 15m | $896,123 | 19 |
| S5131 | Homemaker service nos /diem | $530,389 | 10 |
| S5101 | Adult day care per half day | $170,515 | 11 |
| S0340 | Lifestyle mod 1st stage | $148,000 | 7 |
| S5135 | Adult companioncare per 15m | $57,876 | 8 |
| S9485 | Crisis intervention mental h | $43,803 | 9 |
| S0302 | Completed epsdt | $7,952 | 87 |
| S5125 | Attendant care service /15m | $4,607 | 2 |
| S3005 | Eval self-assess depression | $119 | 1 |
| S0028 | Injection, famotidine, 20 mg | $0 | 16 |
Note: HCPCS codes are provided for context within the category. The totals and rankings in this report are based on standardized service group designations, not on separate billing codes.
The figures in this story come from the U.S. Department of Health and Human Services Medicaid Provider Spending database, accessible here.
