In 2024, Medicaid providers in San Mateo received $22,848,369 for services within the National Codes Established for State Medicaid Agencies category, as reported by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was an 11% rise from 2023, when claims for the same service category totaled $20,588,712.
Medicaid is a public health insurance program administered by states and funded through a partnership between federal and state governments. The program provides coverage for low-income individuals and families, seniors, children, and people with disabilities, and is a significant part of the U.S. health care landscape.
As Medicaid is supported by taxpayer funds, shifts in local billing reflect how public health care resources are distributed in a community.
The “National Codes Established for State Medicaid Agencies” category represents a set of Medicaid-billed services defined by the care provided, grouping standardized HCPCS and CPT codes. For analysis purposes, each billing code was assigned to a single service category using distinctive code prefixes and numeric groupings, ensuring services could be tracked over time while avoiding overlap and maintaining precise rankings.
Medicaid spending increased among several service categories, but National Codes Established for State Medicaid Agencies led all categories in San Mateo for total Medicaid payments in 2024.
Statewide, the National Codes Established for State Medicaid Agencies category also took the top position by total Medicaid payments in California for 2024.
From the period five years prior to 2024, San Mateo’s Medicaid payments tied to this category rose by $12,215,358, or 114.9%. Some periods saw notable year-over-year growth, with significant jumps occurring in 2023 and 2021.
Although payments for these services spanned the city, they were highly concentrated within a few ZIP codes. In 2024, ZIP code 94403 accounted for $19,551,098 of Medicaid payments, 94402 saw $2,853,194, and 94401 recorded $444,076. Combined, the top 3 ZIP codes made up 100% of all Medicaid payments linked to the National Codes Established for State Medicaid Agencies category in San Mateo during the year.
Within this service group, Medicaid payments were also concentrated among a small subset of billing codes.
Between 2024 and 2023, Medicaid payments in San Mateo associated with the National Codes Established for State Medicaid Agencies category climbed 11%, compared to an 8.7% increase across all Medicaid claim types in the city for the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures reached about $871.7 billion in fiscal year 2023, making up nearly 18% of all U.S. health spending and growing substantially from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This growth amounts to an increase of approximately 40% over a few years, fueled in large part by expanded enrollment and greater utilization during and after the pandemic.
Federal budget measures during the Trump administration have included substantial plans to scale back federal Medicaid spending and alter the program structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid expenditures by over $1 trillion throughout the next decade, with new policies such as work requirements and greater cost-sharing that may limit coverage and funding for certain beneficiaries. These adjustments are likely to increase state-level responsibilities and curb the expansion of federal support, even as Medicaid continues to serve millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $10,633,011 | -5.8% |
| 2021 | $12,955,165 | 21.8% |
| 2022 | $14,757,518 | 13.9% |
| 2023 | $20,588,711 | 39.5% |
| 2024 | $22,848,369 | 11% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $22,848,369 | 20.3% |
| 2 | Procedures / Professional Services | $18,921,396 | 16.8% |
| 3 | Alcohol and Drug Abuse Treatment | $17,178,830 | 15.3% |
| 4 | Medicine Services and Procedures | $17,164,733 | 15.3% |
| 5 | Evaluation and Management | $13,779,767 | 12.3% |
| 6 | Anesthesia | $11,910,094 | 10.6% |
| 7 | Pathology and Laboratory Procedures | $3,839,798 | 3.4% |
| 8 | Radiology Procedures | $2,084,036 | 1.9% |
| 9 | Surgery | $2,019,623 | 1.8% |
| 10 | Temporary National Codes (Non-Medicare) | $1,330,649 | 1.2% |
| 11 | Drugs Administered Other than Oral Method | $873,506 | 0.8% |
| 12 | Dental Services | $335,098 | 0.3% |
| 13 | Orthotic Procedures and services | $91,095 | 0.1% |
| 14 | Temporary Codes | $46,292 | <0.1% |
| 15 | Medical And Surgical Supplies | $5,803 | <0.1% |
| 16 | Vision Services | $865 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $16,011,260 | 68 |
| T1017 | Targeted case management | $3,666,154 | 93 |
| T2025 | Waiver service, nos | $2,701,325 | 26 |
| T2021 | Day habil waiver per 15 min | $237,416 | 11 |
| T2024 | Serv asmnt/care plan waiver | $179,113 | 11 |
| T1013 | Sign lang/oral interpreter | $48,279 | 89 |
| T1014 | Telehealth transmit, per min | $4,819 | 11 |
| T1016 | Case management | $0 | 5 |
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.
