In 2024, providers in Half Moon Bay billed Medicaid for $1,928,420 worth of services under the National Codes Established for State Medicaid Agencies, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. That amount represented a 61.4% increase over 2023, when local providers filed $1,194,700 in claims for these services.
Medicaid is a government health insurance program managed by the states and financed both federally and by state governments. It provides coverage for low-income people and families, seniors, children, and those with disabilities, making it one of the largest sectors of the U.S. health care system.
Since taxpayer funds sustain Medicaid payments, changes in local billing patterns show how public health dollars are distributed throughout a community.
The “National Codes Established for State Medicaid Agencies” designation includes a set of Medicaid-billed services categorized by the care type provided, relying on uniform HCPCS and CPT code groupings. For this reporting, each billing code corresponds to a single service category using standard prefixes and number ranges, allowing grouped analysis of related services and avoiding overlap or duplicated counts for ranking purposes.
While Medicaid disbursements grew in various service categories, the National Codes Established for State Medicaid Agencies category claimed the top spot in Half Moon Bay for total Medicaid payments in 2024.
Statewide, in California, this category also ranked first in terms of Medicaid payments for 2024.
Looking at the five years leading into 2024, Medicaid payments connected to the National Codes Established for State Medicaid Agencies in Half Moon Bay increased by $1,560,903, or 424.7%. The pace of spending rose during certain years and showed significant annual increases in both 2023 and 2022.
Although care in the National Codes Established for State Medicaid Agencies covered different parts of Half Moon Bay, payment activity remained concentrated in a small number of ZIP codes. ZIP code 94019 notably accounted for $1,928,420 in 2024, meaning the top ZIP code represented 100% of Medicaid payments tied to this category locally for the year.
Within this segment, Medicaid payments were focused on a restricted set of individual billing codes.
To compare, Medicaid payments to the National Codes Established for State Medicaid Agencies category in Half Moon Bay were up 61.4% from 2023 to 2024, while all other Medicaid claim types in the city rose by 12.1% in the same time frame.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenses reached nearly $871.7 billion during fiscal year 2023, totaling about 18% of U.S. health expenditure, up sharply from around $613.5 billion in 2019 ahead of the COVID-19 pandemic.
This change amounts to a roughly 40% increase over a few years, largely propelled by enrollment growth and higher usage during and after the pandemic.
Recent federal budget legislation from the Trump administration included major proposals to cut federal Medicaid funding and change its structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is set to cut more than $1 trillion in federal Medicaid spending over the coming decade and introduces initiatives such as work requirements and higher cost-sharing, which may decrease benefits and funding for certain enrollees. These measures are projected to place greater fiscal responsibility on states and slow growth in federal Medicaid support, even as the program continues to provide for millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $367,517 | -5.7% |
| 2021 | $437,669 | 19.1% |
| 2022 | $594,885 | 35.9% |
| 2023 | $1,194,699 | 100.8% |
| 2024 | $1,928,420 | 61.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $1,928,420 | 58.3% |
| 2 | Temporary National Codes (Non-Medicare) | $446,548 | 13.5% |
| 3 | Evaluation and Management | $381,787 | 11.5% |
| 4 | Alcohol and Drug Abuse Treatment | $316,344 | 9.6% |
| 5 | Medicine Services and Procedures | $182,170 | 5.5% |
| 6 | Dental Services | $31,093 | 0.9% |
| 7 | Anesthesia | $14,532 | 0.4% |
| 8 | Procedures / Professional Services | $7,475 | 0.2% |
| 9 | Pathology and Laboratory Procedures | $469 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $1,784,803 | 11 |
| T1017 | Targeted case management | $143,616 | 8 |
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.