Procedures and professional services see 8.4% uptick in Los Angeles Medicaid payments in 2024

Dr. Mehmet Oz CMS Administrator
Dr. Mehmet Oz CMS Administrator
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In 2024, Medicaid providers in Los Angeles requested $85,635,113 for Procedures / Professional Services, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount marks an 8.4% increase from 2023, when billings for the same services stood at $79,026,796.

Medicaid operates as a public insurance program administered by states and supported through a combination of federal and state funding. The program covers people with low incomes, seniors, children, and those with disabilities and represents a major component of the U.S. health care infrastructure.

Because taxpayer funding supports Medicaid payments, local billing trends reveal how public health dollars are applied within the community.

The “Procedures / Professional Services” group represents Medicaid-billed care, defined by HCPCS and CPT coding schemes. For the purposes of this data, each code falls into a single service category using uniform code prefixes and numeric ranges. This grouping helps ensure related services are counted together without overlaps and keeps time-series rankings consistent.

Though Medicaid spending grew across multiple categories in Los Angeles, Procedures / Professional Services ranked as the sixth-highest category for Medicaid payments in 2024.

The Procedures / Professional Services category also held the sixth spot statewide in California by Medicaid payment totals in 2024.

Over the five years before 2024, Medicaid payments for Procedures / Professional Services in Los Angeles grew by $68,401,848, translating to an increase of 396.9%. Certain years, notably 2023 and 2021, saw more significant annual growth within this category.

Although these payments reached providers throughout Los Angeles, a limited number of ZIP codes received most funds. In 2024, ZIP code 90020 led with $55,884,747 in Medicaid payments, followed by 90011 at $5,312,913, and 90016 with $4,970,551. Together, these top three ZIP codes represented 77.3% of Medicaid payments for the Procedures / Professional Services category in the city that year.

A relatively small group of billing codes also made up most Medicaid payments within this category.

Comparatively, Medicaid payments for Procedures / Professional Services in Los Angeles climbed 8.4% from 2023 to 2024, while all Medicaid claim categories in the city saw a combined 12.9% change during the same interval.

According to the Centers for Medicare & Medicaid Services, combined Medicaid spending at the state and federal levels reached around $871.7 billion during fiscal year 2023. This amounted to about 18% of all national health spending, a sharp increase from $613.5 billion in 2019 before the COVID-19 pandemic.

This growth equates to an approximate 40% surge over several years, primarily as a result of greater enrollment and increased service utilization connected to the pandemic period and afterward.

In recent years, federal budget actions under the Trump administration have sought to decrease federal Medicaid payments and overhaul program structures. The “One Big Beautiful Bill Act,” signed in 2025, is projected to cut more than $1 trillion from federal Medicaid allocations over 10 years, introducing work requirements and heightened cost-sharing measures that could affect beneficiaries. These policies will shift greater costs to states and may slow future federal contributions even as Medicaid continues to assist millions across the U.S.

Medicaid Payments Tied to Procedures / Professional Services in Los Angeles, California Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $17,233,265 -15.8%
2021 $23,708,686 37.6%
2022 $29,370,642 23.9%
2023 $79,026,795 169.1%
2024 $85,635,112 8.4%
Top Categories by Medicaid Payments in Los Angeles, California, 2024

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%
Top 20 HCPCS Codes Within the Procedures / Professional Services Category in Los Angeles, California, 2024

HCPCS Code Description Medicaid Payments Claims
G2212 Prolong outpt/office vis $48,916,022 1,659
G0300 Hhs/hospice of lpn ea 15 min $11,766,146 59
G9012 Other specified case mgmt $10,468,985 601
G9002 Mccd,maintenance rate $4,514,800 52
G0299 Hhs/hospice of rn ea 15 min $2,499,580 46
G0463 Hospital outpt clinic visit $1,632,226 113
G9008 Mccd,phys coor-care ovrsght $1,521,958 190
G9001 Mccd, initial rate $1,455,200 19
G0378 Hospital observation per hr $856,883 39
G0467 Fqhc visit, estab pt $447,497 497
G9920 Scrning perf and negative $436,610 2,245
G0480 Drug test def 1-7 classes $216,342 72
G0151 Hhcp-serv of pt,ea 15 min $122,401 17
G0500 Mod sedat endo service >5yrs $102,001 68
G0162 Hhc rn e&m plan svs, 15 min $92,916 26
G0481 Drug test def 8-14 classes $68,157 16
G0279 Tomosynthesis, mammo $58,997 114
G6002 Stereoscopic x-ray guidance $50,703 13
G0152 Hhcp-serv of ot,ea 15 min $44,326 11
G8431 Pos clin depres scrn f/u doc $41,285 358

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.



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