In 2024, Medicaid providers in Sumter submitted $1,294,471 in claims for services categorized under Temporary National Codes (Non-Medicare), according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total represents a 55.1% increase over 2023, when claims in the same category amounted to $834,377.
Medicaid is a state-run public health insurance program funded jointly by federal and state governments. It offers health coverage for low-income individuals and families, seniors, children, and people with disabilities, making up a substantial portion of the U.S. health care system.
Because taxpayer dollars support Medicaid payments, changes in local billing levels offer insight into how public health care funding is distributed in a community.
The Temporary National Codes (Non-Medicare) category includes Medicaid-billed services grouped according to standardized HCPCS and CPT codes, based on the type of care provided. Each code for this analysis was assigned to a single service category using uniform code prefixes and numeric ranges, allowing for consistent grouping while avoiding double counting and maintaining ranking accuracy over time.
Despite increases in several service categories, Temporary National Codes (Non-Medicare) ranked fourth in Sumter among all categories for Medicaid payments in 2024.
Statewide in South Carolina, Temporary National Codes (Non-Medicare) placed fifth for total Medicaid payments in 2024.
For the five years leading up to 2024, Medicaid payments in Sumter related to Temporary National Codes (Non-Medicare) grew by $435,606, or 50.7%. Some years saw sharper spending increases, particularly in 2022 and 2021.
Spending in this category locally was dispersed across the city but focused within a few ZIP codes. In 2024, ZIP code 29153 recorded $660,808 in Medicaid payments and 29150 accounted for $633,663. Together, those ZIP codes made up 100% of all Medicaid spending for Temporary National Codes (Non-Medicare) in Sumter that year.
A small number of billing codes accounted for most of the Medicaid spending within the Temporary National Codes (Non-Medicare) category.
By comparison, Medicaid payments attributed to Temporary National Codes (Non-Medicare) in Sumter increased 55.1% between 2024 and 2023, while overall Medicaid claim categories in the city grew by 17% during the same period.
According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid expenditures totaled about $871.7 billion in fiscal year 2023, making up roughly 18% of total national health spending, a marked increase from $613.5 billion in 2019 before the COVID-19 pandemic.
That change represents approximately 40% growth in just a few years, driven largely by expanded enrollment and greater use of services during and following the pandemic.
Recent federal budget actions under the Trump administration have proposed major reductions to federal Medicaid funding and potential program restructuring. As one example, the “One Big Beautiful Bill Act,” signed into law in 2025, is projected to reduce federal Medicaid spending by more than $1 trillion over the next 10 years and introduces requirements such as work mandates and increased cost-sharing, potentially lowering coverage and funding for some beneficiaries. These policy changes are expected to shift additional costs to states and constrain federal Medicaid growth, even as the program continues to serve tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $858,865 | -26.7% |
| 2021 | $947,520 | 10.3% |
| 2022 | $1,235,545 | 30.4% |
| 2023 | $834,376 | -32.5% |
| 2024 | $1,294,471 | 55.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $11,011,303 | 36.8% |
| 2 | Evaluation and Management | $8,346,410 | 27.9% |
| 3 | Medicine Services and Procedures | $4,705,295 | 15.7% |
| 4 | Temporary National Codes (Non-Medicare) | $1,294,471 | 4.3% |
| 5 | Pathology and Laboratory Procedures | $1,224,940 | 4.1% |
| 6 | Dental Services | $663,556 | 2.2% |
| 7 | Surgery | $615,836 | 2.1% |
| 8 | Alcohol and Drug Abuse Treatment | $596,189 | 2% |
| 9 | Radiology Procedures | $498,874 | 1.7% |
| 10 | Procedures / Professional Services | $330,047 | 1.1% |
| 11 | Ambulance and Other Transport Services and Supplies | $242,286 | 0.8% |
| 12 | Durable Medical Equipment | $182,643 | 0.6% |
| 13 | Medical And Surgical Supplies | $144,188 | 0.5% |
| 14 | Drugs Administered Other than Oral Method | $54,408 | 0.2% |
| 15 | Anesthesia | $12,839 | <0.1% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $7,475 | <0.1% |
| 17 | Temporary Codes | $4,389 | <0.1% |
| 18 | Chemotherapy Drugs | $3,319 | <0.1% |
| 19 | Administrative, Miscellaneous and Investigational | $1,755 | <0.1% |
| 20 | Outpatient PPS | $0 | <0.1% |
| 20 | Pathology and Laboratory Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| S5102 | Adult day care per diem | $1,248,208 | 36 |
| S5161 | Emer rspns sys serv permonth | $39,540 | 12 |
| S9152 | Speech therapy, re-eval | $6,723 | 4 |
| S9452 | Nutrition class | $0 | 1 |
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.