Medicaid providers in Milpitas billed $1,589,288 for services in the Procedures / Professional Services category in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 249.9% jump from the $454,233 in claims providers submitted for the same services in 2023.
Medicaid is a state-administered public health insurance program, jointly funded by federal and state governments. It provides coverage to low-income families and individuals, seniors, children, and people with disabilities—making it one of the largest segments of the U.S. health care sector.
Because Medicaid payments use taxpayer dollars, fluctuations in local billing trends help illustrate how community health care resources are distributed.
The “Procedures / Professional Services” label refers to a set of Medicaid-billed services determined by the nature of care provided and based on standard HCPCS and CPT code groupings. For this report, each billing code is allocated to only one service category using code prefixes and number ranges, which allows related services to be grouped together, eliminates duplicate counting, and keeps annual rankings consistent.
Spending increased across several Medicaid service groups, but in 2024 the Procedures / Professional Services category ranked third by payment total in Milpitas.
Statewide in California, Procedures / Professional Services placed sixth among Medicaid service categories by overall payments for 2024.
Looking at the five years prior to 2024, Medicaid payments for Procedures / Professional Services in Milpitas rose by $1,569,880, an 8088.6% increase. Spending climbed most steeply during select years, with significant annual growth in both 2020 and 2021.
Although Procedures / Professional Services payments were disbursed throughout Milpitas, most funding came from just a few ZIP codes. In 2024, ZIP code 95035 alone accounted for $1,589,287 in Procedure / Professional Services payments. This single ZIP made up 100% of Medicaid payments for this category in Milpitas that year.
Within Procedures / Professional Services, payments also concentrated among relatively few individual billing codes.
When compared with the overall Medicaid claim categories, Procedures / Professional Services in Milpitas saw a 249.9% payment increase between 2024 and 2023, while all Medicaid claim categories combined posted an 11.7% change during the same period.
According to the Centers for Medicare & Medicaid Services, total Medicaid spending from both federal and state sources was approximately $871.7 billion in fiscal year 2023, making up around 18% of all U.S. health expenditures. This is a significant increase from the $613.5 billion spent in 2019, prior to the COVID-19 pandemic.
This uptick represents nearly 40% growth over a few years, propelled especially by expanding enrollment and higher use of health care during and after the pandemic.
Recent budget legislation under the Trump administration has advanced major proposals to scale back federal Medicaid spending and make structural changes to the program. The “One Big Beautiful Bill Act,” signed in 2025, is projected to trim more than $1 trillion in federal Medicaid funding across the coming decade. It also introduces work requirements and increased cost-sharing, which could potentially narrow coverage and reduce funding for some beneficiaries. These revisions may transfer a larger share of responsibility to states and slow federal Medicaid growth, while the program continues to serve tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $19,408 | 557.5% |
| 2021 | $72,635 | 274.2% |
| 2022 | $259,920 | 257.8% |
| 2023 | $454,233 | 74.8% |
| 2024 | $1,589,287 | 249.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $8,302,344 | 54.8% |
| 2 | Temporary National Codes (Non-Medicare) | $2,869,150 | 18.9% |
| 3 | Procedures / Professional Services | $1,589,287 | 10.5% |
| 4 | Medicine Services and Procedures | $626,505 | 4.1% |
| 5 | Dental Services | $443,235 | 2.9% |
| 6 | Anesthesia | $412,262 | 2.7% |
| 7 | Temporary Codes | $392,378 | 2.6% |
| 8 | Surgery | $170,910 | 1.1% |
| 9 | Alcohol and Drug Abuse Treatment | $134,410 | 0.9% |
| 10 | Evaluation and Management | $73,831 | 0.5% |
| 11 | Pathology and Laboratory Procedures | $61,847 | 0.4% |
| 12 | Medical And Surgical Supplies | $44,829 | 0.3% |
| 13 | Drugs Administered Other than Oral Method | $27,946 | 0.2% |
| 14 | Vision Services | $5,054 | <0.1% |
| 15 | Radiology Procedures | $845 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G9012 | Other specified case mgmt | $790,724 | 15 |
| G0467 | Fqhc visit, estab pt | $488,645 | 49 |
| G0330 | Facility svs dental rehab | $120,054 | 3 |
| G0299 | Hhs/hospice of rn ea 15 min | $102,389 | 38 |
| G0151 | Hhcp-serv of pt,ea 15 min | $51,283 | 15 |
| G0152 | Hhcp-serv of ot,ea 15 min | $28,689 | 14 |
| G0300 | Hhs/hospice of lpn ea 15 min | $7,492 | 21 |
| G0008 | Admin influenza virus vac | $7 | 4 |
| G0155 | Hhcp-svs of csw,ea 15 min | $0 | 10 |
| G0156 | Hhcp-svs of aide,ea 15 min | $0 | 17 |
| G8935 | Rx ace or arb therapy | $0 | 13 |
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.