In 2024, Medicaid providers in San Mateo collected $18,921,397 for services within the Procedures / Professional Services group, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 149.1% rise from 2023, when providers billed $7,596,248 for the same services.
Medicaid is a public insurance program managed at the state level and jointly financed by the federal and state governments. It serves low-income individuals, families, seniors, children and people with disabilities, making it a major component of the U.S. health care system. Additional funding details are available here.
Since Medicaid funding comes from taxpayers, variations in local billing levels reflect how health care dollars are distributed in the community.
The Procedures / Professional Services group represents a set of Medicaid-billed services determined by type of care, following standardized HCPCS and CPT code groupings. For this report, each billing code was assigned to one service category using standardized prefixes and number ranges to group similar services, reduce double-counting and ensure accurate rankings over time.
Even as Medicaid payments grew in more than one service category, Procedures / Professional Services placed second in total Medicaid billing in San Mateo in 2024.
On a statewide basis, Procedures / Professional Services ranked sixth by Medicaid payment totals in California in 2024.
From the five years before 2024, Medicaid payments in San Mateo connected to Procedures / Professional Services grew by $18,410,601, or 3604.3%. Periods of especially rapid growth, such as in 2023 and 2022, contributed substantially to this trend.
Spending in the Procedures / Professional Services category was distributed across San Mateo, but the majority was concentrated in a few ZIP codes. In 2024, ZIP 94402 accounted for $16,795,821, 94403 for $2,125,572 and 94401 logged $3. These top 3 ZIP codes made up the entire Medicaid spending in this category for San Mateo during 2024.
Within Procedures / Professional Services, Medicaid payments were focused among a limited selection of billing codes.
For context, Medicaid payments in San Mateo connected to Procedures / Professional Services rose 149.1% from 2023 to 2024, while overall Medicaid billing in all service categories increased by 8.7% in the same time period.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid outlays reached about $871.7 billion in fiscal year 2023, making up about 18% of national health expenditures—a sharp increase from roughly $613.5 billion in 2019, prior to COVID-19.
This growth equals an increase of about 40% over a few years, primarily driven by more people enrolling and greater use of services during and after the pandemic.
Recent federal budget actions during the Trump administration included substantial proposals to reduce federal Medicaid spending and overhaul the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid funding by over $1 trillion over 10 years and introduce policies like work requirements and higher cost-sharing, possibly reducing coverage and funding for some beneficiaries. As a result, costs may shift more to states and growth in federal Medicaid support could be restrained, even as the program continues to assist tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $510,796 | -44.7% |
| 2021 | $654,546 | 28.1% |
| 2022 | $1,183,305 | 80.8% |
| 2023 | $7,596,247 | 542% |
| 2024 | $18,921,396 | 149.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $22,848,369 | 20.3% |
| 2 | Procedures / Professional Services | $18,921,396 | 16.8% |
| 3 | Alcohol and Drug Abuse Treatment | $17,178,830 | 15.3% |
| 4 | Medicine Services and Procedures | $17,164,733 | 15.3% |
| 5 | Evaluation and Management | $13,779,767 | 12.3% |
| 6 | Anesthesia | $11,910,094 | 10.6% |
| 7 | Pathology and Laboratory Procedures | $3,839,798 | 3.4% |
| 8 | Radiology Procedures | $2,084,036 | 1.9% |
| 9 | Surgery | $2,019,623 | 1.8% |
| 10 | Temporary National Codes (Non-Medicare) | $1,330,649 | 1.2% |
| 11 | Drugs Administered Other than Oral Method | $873,506 | 0.8% |
| 12 | Dental Services | $335,098 | 0.3% |
| 13 | Orthotic Procedures and services | $91,095 | 0.1% |
| 14 | Temporary Codes | $46,292 | <0.1% |
| 15 | Medical And Surgical Supplies | $5,803 | <0.1% |
| 16 | Vision Services | $865 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G9012 | Other specified case mgmt | $17,546,260 | 124 |
| G0463 | Hospital outpt clinic visit | $466,432 | 10 |
| G2212 | Prolong outpt/office vis | $346,806 | 9 |
| G0467 | Fqhc visit, estab pt | $144,927 | 10 |
| G8510 | Scr dep neg, no plan reqd | $124,353 | 329 |
| G9920 | Scrning perf and negative | $100,842 | 10 |
| G0299 | Hhs/hospice of rn ea 15 min | $41,344 | 11 |
| G0151 | Hhcp-serv of pt,ea 15 min | $40,771 | 13 |
| G0279 | Tomosynthesis, mammo | $35,941 | 29 |
| G9008 | Mccd,phys coor-care ovrsght | $29,008 | 9 |
| G0108 | Diab manage trn per indiv | $18,768 | 10 |
| G2025 | Dis site tele svcs rhc/fqhc | $18,077 | 10 |
| G0152 | Hhcp-serv of ot,ea 15 min | $4,270 | 7 |
| G0466 | Fqhc visit new patient | $1,325 | 2 |
| G8431 | Pos clin depres scrn f/u doc | $593 | 4 |
| G9919 | Scrn nd pos nd prov of rec | $570 | 1 |
| G0155 | Hhcp-svs of csw,ea 15 min | $530 | 1 |
| G0439 | Ppps, subseq visit | $290 | 19 |
| G2211 | Complex e/m visit add on | $279 | 6 |
| G0127 | Trim nail(s) | $3 | 1 |
Note: HCPCS codes are provided for context within the category. The totals and rankings listed here are based on standardized service groupings, not individual billing codes.
Information for this article was sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the source data here.