In 2024, Medicaid providers in Los Angeles submitted $569,995,717 in claims for services listed under the National Codes Established for State Medicaid Agencies category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 3.6% increase from 2023, when total claims for these services reached $549,969,000.
Medicaid, which is overseen by states and gets funding from both federal and state governments, provides public health insurance for low-income individuals, families, children, seniors and people with disabilities—covering one of the nation’s largest patient populations.
Because Medicaid funding comes from public sources, shifts in local billing amounts help reveal how health care dollars are distributed within communities.
The “National Codes Established for State Medicaid Agencies” category groups Medicaid-billed services by the type of care, following standardized HCPCS and CPT code groupings. Each service code in this analysis is assigned to one category, based on code prefixes and numerical segments, so related services are organized together without duplicate counts, maintaining accurate trends and rankings over time.
National Codes Established for State Medicaid Agencies represented the largest category in Los Angeles for total Medicaid payments in 2024, outpacing all others.
Statewide, California also saw National Codes Established for State Medicaid Agencies top its list by total Medicaid payments in 2024.
From five years prior to 2024, Medicaid payments associated with this category in Los Angeles rose by $194,318,343, or 51.7%. Increases in certain years were especially strong, with 2023 and 2021 showing some of the most significant year-over-year gains.
Payments for care under this category in Los Angeles were distributed citywide, but a small group of ZIP codes drew the largest amounts. For 2024, ZIP code 90020 received $116,317,171, ZIP code 90027 saw $63,822,785, and ZIP code 90044 totaled $43,717,200; altogether, these top 3 ZIP codes made up 39.3% of Medicaid payments recorded under the National Codes Established for State Medicaid Agencies category citywide that year.
Within the category, a significant share of Medicaid dollars went to a relatively small subset of specific billing codes.
Looking at the year-to-year growth, Medicaid payments for this category in Los Angeles increased by 3.6% between 2024 and 2023, while all Medicaid claim categories across the city rose by 12.9% during the same time period.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending totaled about $871.7 billion for fiscal year 2023, making up roughly 18% of all spending on health nationally and representing a sharp increase over the $613.5 billion reported in 2019 before the onset of the COVID-19 pandemic.
This increase is equivalent to about 40% in just a few years and has stemmed from broader Medicaid enrollment and higher service use during and after the pandemic.
Recent federal budget legislation passed during the Trump administration included major proposals to scale back federal Medicaid funding and revise program structure. Notably, the “One Big Beautiful Bill Act,” enacted in 2025, is forecast to trim more than $1 trillion from federal Medicaid spending over a decade by rolling out policies such as work requirements and increased beneficiary cost sharing. The changes are set to shift additional costs to states and may constrain future federal spending growth, even as Medicaid continues to cover tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $375,677,373 | 11.8% |
| 2021 | $423,469,650 | 12.7% |
| 2022 | $394,689,470 | -6.8% |
| 2023 | $549,969,000 | 39.3% |
| 2024 | $569,995,717 | 3.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $569,995,717 | 26.5% |
| 2 | Medicine Services and Procedures | $398,580,366 | 18.5% |
| 3 | Alcohol and Drug Abuse Treatment | $359,235,604 | 16.7% |
| 4 | Evaluation and Management | $269,652,307 | 12.5% |
| 5 | Temporary National Codes (Non-Medicare) | $140,525,379 | 6.5% |
| 6 | Procedures / Professional Services | $85,635,112 | 4% |
| 7 | Radiology Procedures | $78,051,848 | 3.6% |
| 8 | Pathology and Laboratory Procedures | $73,729,299 | 3.4% |
| 9 | Anesthesia | $56,555,584 | 2.6% |
| 10 | Dental Services | $38,190,827 | 1.8% |
| 11 | Ambulance and Other Transport Services and Supplies | $19,073,838 | 0.9% |
| 12 | Surgery | $16,031,718 | 0.7% |
| 13 | Drugs Administered Other than Oral Method | $10,971,030 | 0.5% |
| 14 | Temporary Codes | $10,901,505 | 0.5% |
| 15 | Medical And Surgical Supplies | $6,626,671 | 0.3% |
| 16 | Chemotherapy Drugs | $4,580,181 | 0.2% |
| 17 | Durable Medical Equipment | $4,518,507 | 0.2% |
| 18 | Vision Services | $1,246,414 | 0.1% |
| 19 | Hearing Services | $1,235,353 | 0.1% |
| 20 | Administrative, Miscellaneous and Investigational | $913,883 | <0.1% |
| 21 | Enteral and Parenteral Therapy | $881,282 | <0.1% |
| 22 | Outpatient PPS | $520,140 | <0.1% |
| 23 | Pathology and Laboratory Services | $333,333 | <0.1% |
| 24 | Coronavirus Diagnostic Panel | $286,451 | <0.1% |
| 25 | Orthotic Procedures and services | $258,444 | <0.1% |
| 26 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $246,641 | <0.1% |
| 27 | Prosthetic Procedures | $103,990 | <0.1% |
| 28 | Diagnostic Radiology Services | $17,411 | <0.1% |
| 29 | Other Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $323,481,559 | 14,087 |
| T1017 | Targeted case management | $90,904,539 | 2,125 |
| T2033 | Res, nos waiver per diem | $45,434,106 | 59 |
| T2031 | Assist living waiver/diem | $40,146,361 | 296 |
| T2021 | Day habil waiver per 15 min | $24,191,356 | 462 |
| T2051 | Support broker waiver/diem | $11,705,855 | 17 |
| T2041 | Support broker waiver/15 min | $7,163,404 | 53 |
| T2024 | Serv asmnt/care plan waiver | $4,917,775 | 208 |
| T4541 | Large disposable underpad | $3,990,259 | 155 |
| T4535 | Disposable liner/shield/pad | $3,264,880 | 125 |
| T2005 | N-et; stretcher van | $2,463,469 | 12 |
| T4523 | Adult size brief/diaper lg | $2,339,650 | 111 |
| T2003 | N-et; encounter/trip | $1,876,608 | 19 |
| T2017 | Habil res waiver 15 min | $1,422,360 | 10 |
| T4527 | Adult size pull-on lg | $832,314 | 83 |
| T2022 | Case management, per month | $808,144 | 41 |
| T4526 | Adult size pull-on med | $762,725 | 94 |
| T1004 | Nsg aide service up to 15min | $714,011 | 8 |
| T2025 | Waiver service, nos | $578,940 | 42 |
| T1013 | Sign lang/oral interpreter | $497,845 | 221 |
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.
