Redwood City Medicaid bills for Medicine Services and Procedures climb to $4.9M in 2024

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

Redwood City Medicaid providers billed $4,943,012 for Medicine Services and Procedures in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This amounted to a 62.1% growth compared with 2023, when claims for this service totaled $3,049,529.

Medicaid, a public insurance program operated by states and funded by both federal and state governments, serves low-income families and individuals, children, seniors and people with disabilities, and is a key component of the U.S. health care system.

Because taxpayer funds support Medicaid payments, shifts in local claim figures display how public health care resources are used within the community.

The “Medicine Services and Procedures” designation represents a set of Medicaid-billed services grouped by the type of medical care delivered, aligning with standardized HCPCS and CPT code groupings. Each code was allocated to a single category based on code prefixes and number ranges in this analysis, enabling service types to be evaluated together and preventing code overlap to ensure accurate longitudinal rankings.

Medicine Services and Procedures placed fourth in total Medicaid payment category rankings in Redwood City for 2024, even as Medicaid spending expanded across several categories.

Statewide, Medicine Services and Procedures ranked third in California by Medicaid payments for 2024.

In the five years before 2024, Medicaid payments for Medicine Services and Procedures in Redwood City increased by $3,857,165, or 355.2%. Spending rose fastest at certain intervals, with distinct annual increases observed in 2023 and 2022.

Although service payments in this category extended throughout Redwood City, expenditures concentrated heavily in a small number of ZIP codes in 2024. The leading ZIP codes for Medicaid spending in this category included 94063 with $4,180,757, 94061 with $378,064, and 94062 with $216,725. The top 3 ZIP codes made up 96.6% of all Medicaid costs linked to Medicine Services and Procedures in Redwood City that year.

Medicaid billing was also focused on a small group of specific codes within the Medicine Services and Procedures classification.

Comparatively, Medicaid spending on Medicine Services and Procedures in Redwood City increased 62.1% from 2023 to 2024, while Medicaid payments for all claim categories in the city changed by 10.5% during the same period.

According to the Centers for Medicare & Medicaid Services, the combination of state and federal Medicaid spending reached about $871.7 billion nationwide during fiscal year 2023, which comprised approximately 18% of overall U.S. health expenditures, up sharply from roughly $613.5 billion in 2019 before the COVID-19 pandemic.

The increase reflects almost 40% overall growth in only a few years, driven by greater enrollment and rising utilization during and after the pandemic.

Recent federal budgets under the Trump administration have incorporated substantial efforts to reduce Medicaid funding and revise the program structure. For example, the “One Big Beautiful Bill Act,” which became law in 2025, is slated to cut more than $1 trillion in federal Medicaid expenditures over the coming decade. It introduces requirements such as work mandates and higher cost-sharing, potentially restricting coverage and financial support for selected beneficiaries. These changes could shift greater cost responsibility to states and limit the rise of federal Medicaid assistance, though the program will continue to serve millions of Americans.

Medicaid Payments Tied to Medicine Services and Procedures in Redwood City, California Over Five Years

Year Total Medicaid Payments % Change From Previous Year
2020 $1,085,847 -5.8%
2021 $1,021,378 -5.9%
2022 $1,234,929 20.9%
2023 $3,049,529 146.9%
2024 $4,943,012 62.1%
Top Categories by Medicaid Payments in Redwood City, California, 2024

Rank Category Medicaid Payments Share of City Total
1 Pathology and Laboratory Procedures $14,039,043 32.9%
2 National Codes Established for State Medicaid Agencies $9,696,599 22.7%
3 Evaluation and Management $8,006,581 18.8%
4 Medicine Services and Procedures $4,943,012 11.6%
5 Alcohol and Drug Abuse Treatment $2,862,518 6.7%
6 Dental Services $1,099,879 2.6%
7 Radiology Procedures $1,062,954 2.5%
8 Procedures / Professional Services $520,330 1.2%
9 Anesthesia $164,841 0.4%
10 Drugs Administered Other than Oral Method $137,910 0.3%
11 Surgery $50,816 0.1%
12 Temporary National Codes (Non-Medicare) $46,473 0.1%
13 Vision Services $42,193 0.1%
14 Temporary Codes $9,201 <0.1%
15 Medical And Surgical Supplies $6,128 <0.1%
16 Administrative, Miscellaneous and Investigational $1,018 <0.1%
Top 20 HCPCS Codes Within the Medicine Services and Procedures Category in Redwood City, California, 2024

HCPCS Code Description Medicaid Payments Claims
90837 Psytx w pt 60 minutes $1,178,466 27
90999 Unlisted dialysis procedure $970,572 10
91320 Sarscv2 vac 30mcg trs-suc im $460,601 11
90834 Psytx w pt 45 minutes $406,862 18
95144 Antigen therapy services $282,764 22
90480 Admn sarscov2 vac 1/only cmp $234,846 12
96372 Ther/proph/diag inj sc/im $161,979 26
92508 Tx sp lang voice comm group $108,146 19
95004 Perq tests w/alrgnc xtrcs $92,059 18
90962 Esrd serv 1 visit p mo 20+ $76,701 11
95807 Sleep study attended $75,373 9
92507 Tx sp lang voice comm indiv $62,491 18
93010 Electrocardiogram report $61,313 145
97530 Therapeutic activities $60,360 13
90792 Psych diag eval w/med srvcs $59,539 5
90662 Iiv no prsv increased ag im $55,647 3
93306 Tte w/doppler complete $53,624 10
96374 Ther/proph/diag inj iv push $52,200 23
90832 Psytx w pt 30 minutes $40,101 8
93005 Electrocardiogram tracing $33,522 25

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

San Mateo sees $17,164,734 in Medicaid payments for Medicine Services and Procedures in 2024

Medicaid payments for the Medicine Services and Procedures group in San Mateo climbed by 19.3% in 2024, signaling shifts in both utilization and reimbursement practices.

Dr. Mehmet Oz CMS Administrator

Medicaid payments for Medicine Services and Procedures in East Palo Alto climbed to $1,097,928 in 2024

East Palo Alto saw a 96.7% rise in Medicaid payments in the Medicine Services and Procedures category in 2024, indicating shifts in how care is billed and reimbursed.

Dr. Mehmet Oz CMS Administrator

South San Francisco Medicaid spending on Evaluation and Management services climbs to $3,644,319 in 2024

In 2024, Medicaid providers in South San Francisco billed $3,644,319 for Evaluation and Management services, representing a 179.2% increase from the prior year.

Trending

The Weekly Newsletter

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