Burlingame Medicaid providers billed a total of $13,503,265 in 2024 for services falling under the Procedures / Professional Services category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That figure represents a 20.5% rise from 2023, when the same service category saw $11,208,436 in claims.
Medicaid operates as a public health insurance initiative managed by states with joint funding from federal and state governments. It serves low-income families and individuals, older adults, children, and people with disabilities, making it a core element of the nation’s health care system.
Since Medicaid is funded by taxpayers, local variations in billing levels provide insight into the distribution of public health care dollars in a given area.
The Procedures / Professional Services categorization encompasses a set of Medicaid-billed offerings based on the specific care delivered, organized by standardized HCPCS and CPT codes. For this report, each billing code was assigned to one service category, using set code prefixes and number sequences. This method allows grouping of similar services, prevents double counting, and maintains tracking accuracy over multiple years.
Spending expanded in several Medicaid service categories, but Procedures / Professional Services accounted for the highest total Medicaid payments in Burlingame in 2024.
At the state level, this category was sixth in California by overall Medicaid payments in 2024.
Between 2019 and 2024, the Procedures / Professional Services category in Burlingame saw an increase of $11,670,678 in Medicaid payments, marking 636.8% growth. Spending growth quickened during certain intervals, especially across both 2020 and 2021.
Although payments for Procedures / Professional Services were recorded citywide, most were concentrated in a few ZIP codes. For 2024, ZIP code 94010 alone totaled $13,503,264, with the top ZIP code representing 100% of all Medicaid payments in this category in Burlingame for the year.
Additionally, only a small selection of individual billing codes accounted for the majority of Medicaid spending in this service group.
Comparatively, Medicaid payments tied to Procedures / Professional Services in Burlingame grew 20.5% between 2023 and 2024, outpacing the 16.6% increase reported across all Medicaid claim categories in the city during the same period.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid expenses came to about $871.7 billion in fiscal 2023, making up nearly 18% of the nation’s overall health expenditures. That is up considerably from $613.5 billion in 2019 before the COVID-19 pandemic.
This represents approximately 40% growth within a few years, mainly stemming from higher enrollment and greater use of services during and after the pandemic.
Federal budget measures enacted under the Trump administration have included plans to decrease federal Medicaid funding and revise program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid payouts by more than $1 trillion over 10 years and includes provisions such as work requirements and higher cost-sharing, which could lead to reduced coverage and funding for certain groups. These changes may result in increased costs for states and limit how much federal support for Medicaid can grow, while the program continues to cover tens of millions of individuals nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,832,587 | 443.9% |
| 2021 | $4,851,005 | 164.7% |
| 2022 | $7,146,121 | 47.3% |
| 2023 | $11,208,435 | 56.8% |
| 2024 | $13,503,264 | 20.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Procedures / Professional Services | $13,503,264 | 53.2% |
| 2 | Ambulance and Other Transport Services and Supplies | $6,246,939 | 24.6% |
| 3 | Medicine Services and Procedures | $1,794,579 | 7.1% |
| 4 | Evaluation and Management | $1,383,784 | 5.5% |
| 5 | Pathology and Laboratory Procedures | $872,086 | 3.4% |
| 6 | Radiology Procedures | $628,208 | 2.5% |
| 7 | Anesthesia | $505,588 | 2% |
| 8 | Temporary National Codes (Non-Medicare) | $268,804 | 1.1% |
| 9 | Surgery | $126,867 | 0.5% |
| 10 | Drugs Administered Other than Oral Method | $28,678 | 0.1% |
| 11 | Temporary Codes | $13,381 | 0.1% |
| 12 | Administrative, Miscellaneous and Investigational | $2,997 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G0299 | Hhs/hospice of rn ea 15 min | $5,916,584 | 57 |
| G0151 | Hhcp-serv of pt,ea 15 min | $2,863,613 | 53 |
| G0300 | Hhs/hospice of lpn ea 15 min | $1,799,543 | 22 |
| G0152 | Hhcp-serv of ot,ea 15 min | $1,203,262 | 34 |
| G0155 | Hhcp-svs of csw,ea 15 min | $968,767 | 25 |
| G0156 | Hhcp-svs of aide,ea 15 min | $346,563 | 21 |
| G0157 | Hhc pt assistant ea 15 | $200,570 | 14 |
| G0153 | Hhcp-svs of s/l path,ea 15mn | $140,713 | 11 |
| G0493 | Rn care ea 15 min hh/hospice | $52,140 | 6 |
| G0279 | Tomosynthesis, mammo | $5,627 | 10 |
| G0159 | Hhc pt maint ea 15 min | $4,712 | 1 |
| G2211 | Complex e/m visit add on | $918 | 13 |
| G0162 | Hhc rn e&m plan svs, 15 min | $247 | 1 |
| G0008 | Admin influenza virus vac | $0 | 1 |
| G0439 | Ppps, subseq visit | $0 | 6 |
| G0494 | Lpn care ea 15min hh/hospice | $0 | 2 |
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.