In 2024, Medicaid providers in Los Angeles billed $569,995,717 for services under the National Codes Established for State Medicaid Agencies, according to the U.S. Department of Health and Human Services Medicaid Provider Spending data. This figure represents a 3.6% rise from 2023, when the total for the same services was $549,969,000.
Medicaid, administered at the state level and funded by both federal and state governments, provides health coverage to people with low incomes, seniors, children and those with disabilities. The program is a major component of the nation’s health care system.
Because taxpayer funding supports Medicaid, shifts in billing volumes highlight how public health care funding is distributed across communities.
The “National Codes Established for State Medicaid Agencies” represent a collection of Medicaid services grouped by specific care types, using standardized HCPCS and CPT code ranges. Each code was categorized under a single service type for this analysis, using uniform prefixes and number sequences to track related services and prevent duplicate counting, maintaining consistent rankings over time.
While several Medicaid categories saw spending increases, National Codes Established for State Medicaid Agencies led all categories in Los Angeles by total payments in 2024.
Statewide, in California, the National Codes Established for State Medicaid Agencies category also held the top position by total Medicaid payments in 2024.
Looking at a five-year span up to 2024, Los Angeles Medicaid payments associated with the National Codes Established for State Medicaid Agencies climbed by $194,318,343, a 51.7% increase. Notable year-over-year growth occurred in both 2023 and 2021, helping drive this broader trend.
Though payments for services within this category were distributed citywide, several ZIP codes accounted for the bulk of Medicaid reimbursement. The leading ZIP codes in 2024 included 90020, at $116,317,171, 90027 with $63,822,785 and 90044, which received $43,717,200. Combined, these 3 ZIP codes made up 39.3% of total Medicaid payments in this category for the year.
A small subset of individual billing codes within the category accounted for the highest share of Medicaid reimbursement.
To compare, Medicaid payments tied to National Codes Established for State Medicaid Agencies in Los Angeles grew by 3.6% from 2023 to 2024, while all Medicaid claim categories in the city increased by 12.9% over the same period.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid expenditures reached about $871.7 billion in fiscal year 2023, making up around 18% of overall national health spending, a marked rise from $613.5 billion in 2019 before the COVID-19 pandemic.
This equates to roughly 40% growth in just a few years, mainly due to expanded enrollment and increased utilization during and after the pandemic period.
Recent federal budget legislation from the Trump administration included major proposals to cut federal Medicaid spending and restructure the program. The “One Big Beautiful Bill Act,” signed in 2025, is estimated to reduce federal Medicaid expenditures by over $1 trillion over the next decade. The bill introduces work requirements and higher cost-sharing for some enrollees, changes that could lower coverage and federal funding, shifting more responsibility to states even as the program continues to serve millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $375,677,373 | 11.8% |
| 2021 | $423,469,650 | 12.7% |
| 2022 | $394,689,470 | -6.8% |
| 2023 | $549,969,000 | 39.3% |
| 2024 | $569,995,717 | 3.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $569,995,717 | 26.5% |
| 2 | Medicine Services and Procedures | $398,580,366 | 18.5% |
| 3 | Alcohol and Drug Abuse Treatment | $359,235,604 | 16.7% |
| 4 | Evaluation and Management | $269,652,307 | 12.5% |
| 5 | Temporary National Codes (Non-Medicare) | $140,525,379 | 6.5% |
| 6 | Procedures / Professional Services | $85,635,112 | 4% |
| 7 | Radiology Procedures | $78,051,848 | 3.6% |
| 8 | Pathology and Laboratory Procedures | $73,729,299 | 3.4% |
| 9 | Anesthesia | $56,555,584 | 2.6% |
| 10 | Dental Services | $38,190,827 | 1.8% |
| 11 | Ambulance and Other Transport Services and Supplies | $19,073,838 | 0.9% |
| 12 | Surgery | $16,031,718 | 0.7% |
| 13 | Drugs Administered Other than Oral Method | $10,971,030 | 0.5% |
| 14 | Temporary Codes | $10,901,505 | 0.5% |
| 15 | Medical And Surgical Supplies | $6,626,671 | 0.3% |
| 16 | Chemotherapy Drugs | $4,580,181 | 0.2% |
| 17 | Durable Medical Equipment | $4,518,507 | 0.2% |
| 18 | Vision Services | $1,246,414 | 0.1% |
| 19 | Hearing Services | $1,235,353 | 0.1% |
| 20 | Administrative, Miscellaneous and Investigational | $913,883 | <0.1% |
| 21 | Enteral and Parenteral Therapy | $881,282 | <0.1% |
| 22 | Outpatient PPS | $520,140 | <0.1% |
| 23 | Pathology and Laboratory Services | $333,333 | <0.1% |
| 24 | Coronavirus Diagnostic Panel | $286,451 | <0.1% |
| 25 | Orthotic Procedures and services | $258,444 | <0.1% |
| 26 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $246,641 | <0.1% |
| 27 | Prosthetic Procedures | $103,990 | <0.1% |
| 28 | Diagnostic Radiology Services | $17,411 | <0.1% |
| 29 | Other Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $323,481,559 | 14,087 |
| T1017 | Targeted case management | $90,904,539 | 2,125 |
| T2033 | Res, nos waiver per diem | $45,434,106 | 59 |
| T2031 | Assist living waiver/diem | $40,146,361 | 296 |
| T2021 | Day habil waiver per 15 min | $24,191,356 | 462 |
| T2051 | Support broker waiver/diem | $11,705,855 | 17 |
| T2041 | Support broker waiver/15 min | $7,163,404 | 53 |
| T2024 | Serv asmnt/care plan waiver | $4,917,775 | 208 |
| T4541 | Large disposable underpad | $3,990,259 | 155 |
| T4535 | Disposable liner/shield/pad | $3,264,880 | 125 |
| T2005 | N-et; stretcher van | $2,463,469 | 12 |
| T4523 | Adult size brief/diaper lg | $2,339,650 | 111 |
| T2003 | N-et; encounter/trip | $1,876,608 | 19 |
| T2017 | Habil res waiver 15 min | $1,422,360 | 10 |
| T4527 | Adult size pull-on lg | $832,314 | 83 |
| T2022 | Case management, per month | $808,144 | 41 |
| T4526 | Adult size pull-on med | $762,725 | 94 |
| T1004 | Nsg aide service up to 15min | $714,011 | 8 |
| T2025 | Waiver service, nos | $578,940 | 42 |
| T1013 | Sign lang/oral interpreter | $497,845 | 221 |
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.
