San Francisco Medicaid payments for National Codes Established for State Medicaid Agencies reach $122.7 million in 2024

San Francisco Medicaid providers reported $122,692,189 in billing for services categorized under the National Codes Established for State Medicaid Agencies in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects a 6.9% rise compared with 2023, when claims for these services reached $114,797,405.

Medicaid, funded jointly by state and federal governments, is a public health insurance program administered by states. It provides coverage for low-income individuals and families, children, seniors, and people with disabilities, positioning it as one of the nation’s largest health care programs.

Since taxpayers fund Medicaid payments, fluctuations in local billing highlight how public health care dollars are allocated at the community level.

The “National Codes Established for State Medicaid Agencies” category groups Medicaid services by the type of care, based on standardized HCPCS and CPT coding conventions. For this report, each billing code aligned with a single service category defined by consistent code prefixes and numeric ranges, enabling an analysis of related service volumes while avoiding double counting and supporting accurate trend rankings.

Spend in multiple Medicaid service categories grew, but National Codes Established for State Medicaid Agencies recorded the highest payment total in San Francisco in 2024.

Statewide across California, the National Codes Established for State Medicaid Agencies category topped Medicaid payments by total in 2024.

Throughout the five years prior to 2024, Medicaid payments associated with this category in San Francisco grew by $43,053,448, or 54.1%. Accelerated spending occurred at certain points, with notable annual increases recorded during 2023 and 2021.

Payments for services in this category were distributed citywide, though a handful of ZIP codes received the majority. In 2024, ZIP codes 94110, 94103, and 94133 led the city, totaling $40,929,742, $26,135,981, and $16,453,894, respectively. These top 3 ZIP codes collectively made up 68.1% of all 2024 category payments in San Francisco.

Within the National Codes Established for State Medicaid Agencies grouping, a smaller number of distinct billing codes accounted for most Medicaid payments.

Between 2024 and 2023, citywide Medicaid payments tied to the category increased by 6.9%, while all other Medicaid claim categories combined saw a 14.5% change in the same period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures totaled approximately $871.7 billion in fiscal year 2023, making up close to 18% of overall U.S. health spending, up sharply from $613.5 billion in 2019 prior to the COVID-19 pandemic.

This growth signifies an overall increase of about 40% in just a few years, largely a result of expanded enrollment and increased utilization during and after the pandemic period.

Recent federal budget law under the Trump administration features major proposals to decrease federal Medicaid spending and alter program design. The “One Big Beautiful Bill Act,” signed into law in 2025, is set to reduce federal Medicaid funding by over $1 trillion during the coming decade and brings in new requirements such as work mandates and more cost-sharing, potentially limiting coverage and resources for certain recipients. As a result, greater expenses may shift to states and growth in federal support is likely to slow, despite Medicaid still serving tens of millions nationwide.

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.