Medicaid medicine services in Menlo Park rise to $1.25 million in 2024, showing 14.3% increase

Dr. Mehmet Oz CMS Administrator
Dr. Mehmet Oz CMS Administrator
0Comments

Menlo Park Medicaid providers billed $1,247,811 for services under the Medicine Services and Procedures category in 2024, the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This amount represents a 14.3% rise from 2023, when claims for the same service type reached $1,091,398.

Medicaid, the public insurance program administered by the states and funded by both federal and state governments, covers seniors, people with disabilities, low-income individuals and families, and children. As such, it is one of the country’s major health care programs.

Because Medicaid funds are derived from taxpayers, fluctuations in billing show how public health spending is distributed within communities.

The “Medicine Services and Procedures” group represents Medicaid-billed care as defined by standardized HCPCS and CPT code set groupings. For this analysis, providers had billing codes assigned to a service category by consistent code ranges and prefixes, enabling groups of related services to be tracked accurately over time without double counting.

Medicine Services and Procedures made up the top Medicaid payment category in Menlo Park in 2024, as spending grew across multiple service types.

Statewide in California, Medicine Services and Procedures stood as the third-largest category by Medicaid payment in 2024.

Between 2020 and 2024, payments in Menlo Park for Medicine Services and Procedures rose $317,706, or 34.2%. There was a rapid uptick in some years, especially with strong annual increases seen in 2023 and 2022.

Though care spending in this category occurred citywide, most payments concentrated in a small group of ZIP codes. In 2024, ZIP code 94025 accounted for $1,247,811, and collectively, the top 1 ZIP codes represented all Medicaid payments tied to this service group in Menlo Park for the year.

Individual HCPCS and CPT billing codes also made up the bulk of payments within Medicine Services and Procedures.

Comparing change, Menlo Park’s Medicaid payments for the Medicine Services and Procedures category were up 14.3% from 2023 to 2024, while spending for all Medicaid categories citywide grew 31% over the same timeframe.

According to the Centers for Medicare & Medicaid Services, total Medicaid spending by federal and state governments reached about $871.7 billion during fiscal year 2023, accounting for about 18% of national health expenditures. This compares to roughly $613.5 billion in 2019, prior to the pandemic.

This growth amounts to around a 40% jump over just a few years, powered primarily by expanded program eligibility and increased service use during and after the pandemic.

Recent federal budget measures under the Trump administration have featured major proposals aimed at reducing federal Medicaid support and restructuring the program. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is set to cut more than $1 trillion in federal Medicaid spending over a decade and brings new rules like work requirements and higher cost sharing, potentially reducing coverage for certain enrollees. Such measures could require states to assume more costs even while Medicaid continues to provide coverage to millions.

Medicaid Payments Tied to Medicine Services and Procedures in Menlo Park, California Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $930,104 -5.8%
2021 $897,753 -3.5%
2022 $916,229 2.1%
2023 $1,091,398 19.1%
2024 $1,247,811 14.3%
Top Categories by Medicaid Payments in Menlo Park, California, 2024

Rank Category Medicaid Payments Share of City Total
1 Medicine Services and Procedures $1,247,811 62.6%
2 National Codes Established for State Medicaid Agencies $407,344 20.4%
3 Enteral and Parenteral Therapy $82,498 4.1%
4 Evaluation and Management $56,509 2.8%
5 Pathology and Laboratory Procedures $37,192 1.9%
6 Alcohol and Drug Abuse Treatment $36,600 1.8%
7 Surgery $35,128 1.8%
8 Medical And Surgical Supplies $31,567 1.6%
9 Temporary Codes $27,580 1.4%
10 Durable Medical Equipment $22,431 1.1%
11 Drugs Administered Other than Oral Method $6,246 0.3%
12 Temporary National Codes (Non-Medicare) $2,176 0.1%
Top 20 HCPCS Codes Within the Medicine Services and Procedures Category in Menlo Park, California, 2024

HCPCS Code Description Medicaid Payments Claims
90999 Unlisted dialysis procedure $1,184,966 10
92250 Fundus photography w/i&r $47,950 10
96131 Psycl tst eval phys/qhp ea $10,552 1
90791 Psych diagnostic evaluation $4,341 2
99600 Unlisted home visit svc/px $0 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.



Related

Dr. Mehmet Oz CMS Administrator

South San Francisco Medicaid spending on medicine services reaches $2,378,796 in 2024

Medicaid spending for the Medicine Services and Procedures category in South San Francisco climbed by 29.1% in 2024, signaling shifts in service usage and payment rates.

Dr. Mehmet Oz CMS Administrator

Redwood City sees 28.6% increase in Medicaid dental service payments in 2024

Medicaid payments for Dental Services in Redwood City grew by 28.6% in 2024, indicating shifts in utilization and reimbursement trends.

Dr. Mehmet Oz CMS Administrator

Medicaid payments for medicine services and procedures climb 54.2% in 2024 in San Carlos

San Carlos saw a 54.2% rise in Medicaid payments for Medicine Services and Procedures in 2024, highlighting shifts in both reimbursement and utilization trends.

Trending

The Weekly Newsletter

Sign-up for the Weekly Newsletter from San Mateo Sun.