Milpitas Medicaid services billed $8,302,344 under National Codes Established for State Medicaid Agencies in 2024

In 2024, Medicaid providers in Milpitas submitted $8,302,344 in claims for services grouped within the National Codes Established for State Medicaid Agencies category, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 2.5% rise from 2023 when providers billed $8,102,053 for the same services.

Medicaid operates as a public health insurance initiative for low-income families, individuals, seniors, children, and those with disabilities, funded collaboratively by state and federal governments. It is considered one of the largest segments of the national health care system.

Because Medicaid funding is tax-based, variations in local billing mirror how public health resources are distributed within a community.

The “National Codes Established for State Medicaid Agencies” grouping consists of Medicaid billing categories defined by care type, utilizing standardized HCPCS and CPT code classifications. For this assessment, each code was assigned to a single service group with standardized code prefixes and numeric intervals, permitting the grouping of related services while avoiding double counting and maintaining accurate rankings over time.

Milpitas saw the National Codes Established for State Medicaid Agencies lead all other service categories by total Medicaid payments in 2024.

Statewide in California, this category also ranked at the top for total Medicaid payments in 2024.

Medicaid payments linked to the National Codes Established for State Medicaid Agencies in Milpitas grew by $3,120,383, or 60.2%, between 2019 and 2024. Certain years, notably 2021 and 2023, saw more rapid year-over-year growth.

Payments for care under this category were distributed throughout Milpitas, but were largely concentrated within a few ZIP codes. In 2024, ZIP code 95035 accounted for $8,302,344 in Medicaid payments tied to the National Codes Established for State Medicaid Agencies grouping. As such, this ZIP code represented 100% of the total for this service type in the city during the year.

Spending was further consolidated among a small number of billing codes within the National Codes Established for State Medicaid Agencies category.

Between 2023 and 2024, Medicaid payments in Milpitas’ National Codes Established for State Medicaid Agencies segment rose 2.5%, while total payments across all claim categories citywide grew 11.7% during the same comparison period.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending totaled about $871.7 billion in fiscal year 2023, which accounts for approximately 18% of all U.S. health expenditures. That figure rose significantly from $613.5 billion in 2019, before the COVID-19 pandemic.

This increase reflects nearly 40% growth over several years, attributed primarily to greater enrollment and utilization after and during the pandemic.

Recent federal budget acts signed during the Trump administration included major proposals for federal Medicaid funding reductions and program restructuring. Provisions in the “One Big Beautiful Bill Act,” effective 2025, are set to reduce federal Medicaid spending by more than $1 trillion over 10 years and include work requirement policies along with enhanced cost-sharing, which could restrict access and decrease funding for some recipients. These policy changes are anticipated to push additional costs onto states while capping increases in federal Medicaid support, despite the program serving tens of millions of Americans.

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.