Austin Medicaid providers billed $210,346 for services categorized under Durable medical equipment (DME) Medicare administrative contractors (MACs) in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. That figure is up 6.9% from 2023, when $196,703 worth of claims were filed in the same category.
Medicaid is a publicly funded health insurance program, managed by the states and supported by both state and federal governments. It serves low-income populations including children, seniors, people with disabilities, and families, making it one of the nation’s largest health care programs.
Since Medicaid reimbursements use taxpayer funds, local changes in claim amounts give insight into community distribution of public health care resources.
The “Durable medical equipment (DME) Medicare administrative contractors (MACs)” grouping refers to a set of Medicaid-billed services defined by the care provided, as established by specific HCPCS and CPT coding systems. For this examination, codes were organized into exclusive service categories by applying standardized prefixes and numeric groupings, enabling analysis without code overlap or ranking inaccuracies over time.
Durable medical equipment (DME) Medicare administrative contractors (MACs) ranked as the 20th largest Medicaid category by total payment amount in Austin for 2024, despite overall Medicaid spending increases across more service categories.
At the state level in Texas, the Durable medical equipment (DME) Medicare administrative contractors (MACs) category also placed 20th in overall Medicaid payments in 2024.
Between 2019 and 2024, Austin Medicaid expenditures for this category grew by $172,396—or 454.3%. The pace of growth accelerated in some years, particularly with significant increases during 2020 and 2021.
Although services in this Medicaid category were available citywide, the majority of payments were concentrated in a few ZIP codes. For 2024, ZIP code 78741 led with $155,546 in Medicaid allocations for this category, followed by 78744 with $30,215, and 78758 at $21,427. These three areas together made up 98.5% of related Medicaid payments in Austin for the year.
A small subset of individual billing codes within the Durable medical equipment (DME) Medicare administrative contractors (MACs) category received most Medicaid payments in Austin.
From 2023 to 2024, payments in this Austin category rose 6.9%, compared to a 13.8% growth rate seen across all Medicaid billing categories citywide over the same period.
The Centers for Medicare & Medicaid Services reports combined state and federal Medicaid expenditures hit approximately $871.7 billion for the 2023 fiscal year, or about 18% of the nation’s total health care outlays. That’s a marked increase from the nearly $613.5 billion spent in 2019, before the COVID-19 pandemic.
The roughly 40% growth during that period is mainly attributed to increased enrollment levels and intensified utilization in response to pandemic-related needs and after-effects.
Washington has enacted recent federal budget changes aiming to significantly reduce Medicaid spending and alter program operations. In particular, the “One Big Beautiful Bill Act,” which became law in 2025, is expected to cut over $1 trillion from federal Medicaid support over the next 10 years and implements new requirements such as mandatory employment and higher cost-sharing—both changes that could limit access for certain recipients. States are likely to face more financial responsibility for Medicaid costs, while federal contributions are set to slow, despite ongoing demand for the program nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $37,950 | 9900.6% |
| 2021 | $148,127 | 290.3% |
| 2022 | $221,138 | 49.3% |
| 2023 | $196,703 | -11.1% |
| 2024 | $210,345 | 6.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $206,790,326 | 28.2% |
| 2 | Alcohol and Drug Abuse Treatment | $163,543,607 | 22.3% |
| 3 | National Codes Established for State Medicaid Agencies | $162,337,342 | 22.1% |
| 4 | Enteral and Parenteral Therapy | $50,350,138 | 6.9% |
| 5 | Pathology and Laboratory Procedures | $48,160,065 | 6.6% |
| 6 | Evaluation and Management | $36,539,464 | 5% |
| 7 | Dental Services | $17,588,677 | 2.4% |
| 8 | Radiology Procedures | $16,114,448 | 2.2% |
| 9 | Medicine Services and Procedures | $10,605,964 | 1.4% |
| 10 | Medical And Surgical Supplies | $7,451,366 | 1% |
| 11 | Ambulance and Other Transport Services and Supplies | $4,571,701 | 0.6% |
| 12 | Durable Medical Equipment | $4,148,800 | 0.6% |
| 13 | Procedures / Professional Services | $1,644,016 | 0.2% |
| 14 | Surgery | $1,003,191 | 0.1% |
| 15 | Orthotic Procedures and services | $788,305 | 0.1% |
| 16 | Miscellaneous Medical Services | $679,740 | 0.1% |
| 17 | Anesthesia | $533,339 | 0.1% |
| 18 | Vision Services | $354,499 | <0.1% |
| 19 | Administrative, Miscellaneous and Investigational | $221,463 | <0.1% |
| 20 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $210,345 | <0.1% |
| 21 | Drugs Administered Other than Oral Method | $61,846 | <0.1% |
| 22 | Diagnostic Radiology Services | $44,708 | <0.1% |
| 23 | Coronavirus Diagnostic Panel | $27,173 | <0.1% |
| 24 | Temporary Codes | $4,630 | <0.1% |
| 25 | Chemotherapy Drugs | $877 | <0.1% |
| 26 | Hearing Services | $556 | <0.1% |
| 27 | Outpatient PPS | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| K0108 | W/c component-accessory nos | $137,685 | 16 |
| K0003 | Lightweight wheelchair | $21,958 | 11 |
| K0739 | Repair/svc dme non-oxygen eq | $20,308 | 16 |
| K0001 | Standard wheelchair | $19,728 | 35 |
| K0738 | Portable gas oxygen system | $5,810 | 16 |
| K0040 | Adjustable angle footplate | $4,179 | 4 |
| K0195 | Elevating whlchair leg rests | $674 | 4 |
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.
