Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows that Appleton Medicaid providers billed $3,266,335 for services within the Temporary National Codes (Non-Medicare) category in 2024. This represents a 541.1% jump from 2023, when claims for these services totaled $509,525.
Medicaid is a state-administered, publicly funded health insurance initiative that receives joint financial support from state and federal governments. Covering low-income families and individuals, seniors, children, and those with disabilities, Medicaid is one of the nation’s most substantial health care programs.
Since Medicaid is taxpayer-funded, adjustments in billing levels at the local level indicate how public health care resources are distributed within a community.
The “Temporary National Codes (Non-Medicare)” grouping encompasses Medicaid-billed services based on the standardized care type, shaped by core HCPCS and CPT code classifications. This research categorized billing codes with defined prefixes and numeric brackets, letting related services be examined together while maintaining unduplicated counts and accurate trends.
Temporary National Codes (Non-Medicare) placed third by total Medicaid reimbursement among service types in Appleton in 2024, despite overall spending gains across several categories.
At the state level, the Temporary National Codes (Non-Medicare) segment ranked sixth in total Medicaid payments for Wisconsin in 2024.
During the five-year span ending in 2024, Appleton Medicaid payments associated with Temporary National Codes (Non-Medicare) grew by $2,640,741—a rise of 422.1%. The growth rate accelerated in selected years, with marked increases taking place in 2021 and 2022.
Although services billed under the Temporary National Codes (Non-Medicare) rubric occurred citywide, the majority of payments were concentrated within several ZIP codes. In 2024, the highest Medicaid payment figures linked to these services were recorded in ZIP code 54915 with $2,108,194, followed by 54913 with $709,837, and 54911 at $329,758. Combined, these 3 ZIP codes made up 96.4% of all related payments in Appleton for the year.
A small number of billing codes accounted for most Medicaid payment volume within the Temporary National Codes (Non-Medicare) category.
Compared to a 541.1% year-over-year increase in Medicaid payments for Temporary National Codes (Non-Medicare) in Appleton between 2024 and 2023, the total rise across all Medicaid categories was far lower at 1.7% during the same interval.
According to the Centers for Medicare & Medicaid Services, total state and federal spending on Medicaid reached roughly $871.7 billion in fiscal year 2023, which represented about 18% of overall U.S. health expenditures—up from nearly $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This reflects approximately 40% growth over just a few years, mostly attributable to broader program enrollment and increased service usage both during and after the pandemic period.
Recent federal budget actions under the Trump administration brought forward substantial changes to Medicaid, including proposals for federal funding reductions and program restructuring. The “One Big Beautiful Bill Act,” passed in 2025, is expected to reduce federal Medicaid spending by over $1 trillion in the upcoming decade and has introduced provisions like work requirements and higher participant cost sharing. These elements may curtail coverage for certain beneficiaries and shift a greater share of Medicaid expenses to states, even as the program continues to serve tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $625,593 | -25.7% |
| 2021 | $752,654 | 20.3% |
| 2022 | $824,246 | 9.5% |
| 2023 | $509,525 | -38.2% |
| 2024 | $3,266,334 | 541.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $10,773,921 | 29.5% |
| 2 | Alcohol and Drug Abuse Treatment | $9,349,584 | 25.6% |
| 3 | Temporary National Codes (Non-Medicare) | $3,266,334 | 8.9% |
| 4 | Procedures / Professional Services | $2,752,443 | 7.5% |
| 5 | Medicine Services and Procedures | $2,693,244 | 7.4% |
| 6 | Evaluation and Management | $2,583,047 | 7.1% |
| 7 | Pathology and Laboratory Procedures | $2,255,418 | 6.2% |
| 8 | Dental Services | $489,900 | 1.3% |
| 9 | Durable Medical Equipment | $432,210 | 1.2% |
| 10 | Medical And Surgical Supplies | $422,927 | 1.2% |
| 11 | Surgery | $416,837 | 1.1% |
| 12 | Radiology Procedures | $356,349 | 1% |
| 13 | Drugs Administered Other than Oral Method | $315,894 | 0.9% |
| 14 | Administrative, Miscellaneous and Investigational | $138,793 | 0.4% |
| 15 | Enteral and Parenteral Therapy | $88,211 | 0.2% |
| 16 | Vision Services | $84,928 | 0.2% |
| 17 | Orthotic Procedures and services | $72,587 | 0.2% |
| 18 | Chemotherapy Drugs | $20,256 | 0.1% |
| 19 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $15,804 | <0.1% |
| 20 | Ambulance and Other Transport Services and Supplies | $5,576 | <0.1% |
| 21 | Hearing Services | $397 | <0.1% |
| 22 | Temporary Codes | $95 | <0.1% |
| 23 | Outpatient PPS | $88 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| S5130 | Homaker service nos per 15m | $2,052,582 | 29 |
| S5135 | Adult companioncare per 15m | $733,662 | 11 |
| S5125 | Attendant care service /15m | $227,414 | 8 |
| S0215 | Nonemerg transp mileage | $64,946 | 11 |
| S8990 | Pt or manip for maint | $62,371 | 7 |
| S5190 | Wellness assessment by nonph | $57,352 | 9 |
| S4993 | Contraceptive pills for bc | $44,992 | 12 |
| S5111 | Family homecare train/sessio | $23,013 | 3 |
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.
