Downey Medicaid payments for National Codes Established category hit $18.8 million in 2024

In 2024, Medicaid providers in Downey billed a total of $18,783,490 for services in the National Codes Established for State Medicaid Agencies category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This figure represents an 11% increase from 2023, when claims in this service category totaled $16,922,671.

Medicaid, a state-administered program funded jointly by the federal and state governments, provides coverage for low-income residents, families, older adults, children, and those with disabilities. It remains a central part of the U.S. health care framework.

Since Medicaid payments draw from taxpayer dollars, variations in local Medicaid billing reflect how health care resources are distributed within communities.

The “National Codes Established for State Medicaid Agencies” grouping comprises Medicaid-eligible services defined by care type, categorized based on standardized HCPCS and CPT coding. For this report, codes were organized into service categories using consistent prefixes and number ranges, helping group similar services, preventing duplicate counting, and accurately ranking spending trends over multiple years.

Across service categories, this group had the highest Medicaid spending in Downey for 2024.

Statewide in California, National Codes Established for State Medicaid Agencies also ranked at the top by total payments in 2024.

Between 2019 and 2024, Downey’s Medicaid payments for this service group climbed $10,234,486, or 119.7%, with spending accelerating at several points, particularly in 2023 and 2021 as year-over-year jumps were observed.

Medicaid payments for care in this category were distributed throughout Downey, though a majority came from a small subset of ZIP codes. In 2024, ZIP code 90241 logged $10,569,841 in relevant Medicaid payments, while 90242 accounted for $8,213,647. Together, these 2 ZIP codes comprised the entire Medicaid spend for this category in Downey during the year.

Payments in the National Codes Established for State Medicaid Agencies category largely centered on a small number of individual billing codes.

For comparison, Downey’s Medicaid payments for this category grew by 11% from 2023 to 2024, outpacing the 2.2% change recorded across all Medicaid claims in the city for the same period.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending combined reached roughly $871.7 billion in fiscal year 2023, making up about 18% of the nation’s total health care expenditures. This is up from about $613.5 billion in 2019, before the COVID-19 pandemic.

This jump means spending surged about 40% within just a few years, mainly due to increased participation and utilization during and after the pandemic.

Legislation passed during the Trump administration has introduced major proposals to reduce and restructure federal Medicaid funding. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion in the next decade. It brings policies such as new work requirements and higher cost-sharing that may limit coverage and funding for certain enrollees. These changes are likely to shift costs to states and restrict the rise of federal Medicaid contributions, even as Medicaid remains a vital safety net for millions.

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.