San Francisco’s Medicaid payments for Procedures / Professional Services reach $32.2 million in 2024

In 2024, providers in San Francisco billed a total of $32,186,447 to Medicaid for services in the Procedures / Professional Services category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This amount reflects a 58.7% increase from 2023, when billed claims in this same category totaled $20,276,892.

Medicaid, a program overseen by individual states and funded in partnership with federal and state governments, provides health coverage for low-income families and individuals, children, seniors, and those with disabilities. It is a key component of the U.S. health system by enrollment.

Taxpayer funding of Medicaid means fluctuations in local billing trends directly impact the distribution of public health care spending in each community.

The “Procedures / Professional Services” classification groups together Medicaid-billed services according to the nature of care provided, defined by standard HCPCS and CPT coding structures. For this report, each procedure code was mapped to a single service group using consistent code prefixes and number ranges to ensure services are tracked over time without double counting and to maintain reliable rankings.

Spending on Procedures / Professional Services grew along with other Medicaid categories, ranking as the sixth-largest service group by Medicaid dollars in San Francisco for 2024.

Statewide, Procedures / Professional Services also held the number six spot for Medicaid spending in California for 2024.

Between 2019 and 2024, Medicaid spending for Procedures / Professional Services in San Francisco climbed by $28,130,894, a 693.6% increase. Growth in expenditures was especially marked at several points, notably with sizeable year-over-year jumps in 2023 and 2021.

While all parts of San Francisco saw Medicaid spending for Procedures / Professional Services, most payments were concentrated within just a few ZIP codes. In 2024, ZIP code 94103 accounted for $11,122,648, 94110 for $8,070,304, and 94158 for $4,604,400. These top three ZIP codes represented 73.9% of all Medicaid payments for this category in the area for the year.

Analysis of the Procedures / Professional Services category found that payments were largely driven by a select few procedure codes.

Comparing 2024 with 2023, the Procedures / Professional Services category in San Francisco experienced a 58.7% payment rise, while all Medicaid claim categories in the city saw a 14.5% increase.

Data from the Centers for Medicare & Medicaid Services show that combined federal and state Medicaid expenditures reached about $871.7 billion in fiscal year 2023, making up roughly 18% of total national health spending—an increase from approximately $613.5 billion in 2019 before the COVID-19 pandemic.

This reflects about 40% growth in just a few years, mainly resulting from greater Medicaid enrollment and use during the pandemic and following recovery phases.

Recent federal budget actions under the Trump administration introduced significant changes to Medicaid funding, including substantial proposed reductions and program restructuring. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut more than $1 trillion in federal Medicaid spending over a decade and has provisions for work requirements and increased cost-sharing, measures that could decrease access and funding for some enrollees. Such changes are likely to shift a larger share of Medicaid costs to states and may limit federal program growth, even as Medicaid remains critical for tens of millions of Americans.

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.