In 2024, Medicaid providers in Grover Beach submitted $354,491 in claims for Medicine Services and Procedures, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represented a 25.8% rise over 2023, when claims for the same service type totaled $281,824.
Medicaid, a health coverage program run at the state level and funded in partnership by federal and state governments, serves low-income individuals and families, older adults, children, and those with disabilities. It remains a substantial part of the nation’s health care system.
Because taxpayer funds support Medicaid programs, any fluctuations in local billing reflect how public health resources are used in the community.
The “Medicine Services and Procedures” group is defined by Medicaid using HCPCS and CPT billing codes, organizing services by the type of care provided. This review assigned each code to a single service category using standardized prefixes and numeric intervals, helping to group related services for analysis and remove duplicate counts in annual rankings.
While Medicaid spending grew across different categories, Medicine Services and Procedures represented the second-highest total for Grover Beach Medicaid payments in 2024.
Statewide in California, Medicine Services and Procedures ranked third among Medicaid payment categories that year.
Medicaid payments for Medicine Services and Procedures in Grover Beach increased by $338,650—or 2137.8%—over the five years leading up to 2024, with sharp year-over-year gains noted in 2023 and 2021.
Although care was delivered citywide, Medicaid payments for Medicine Services and Procedures were concentrated in a small number of ZIP codes. In 2024, ZIP code 93433 accounted for $354,490, making up 100% of Grover Beach’s Medicaid spending for this category during the period.
Within Medicine Services and Procedures, claims were primarily tied to a limited range of individual billing codes.
Compared with all Medicaid claim categories in Grover Beach, which saw a 25.2% increase, Medicine Services and Procedures claims rose by 25.8% from 2023 to 2024.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid expenditures were estimated at $871.7 billion for fiscal year 2023, making up about 18% of total national health costs, a sharp jump from $613.5 billion in 2019 before the COVID-19 pandemic.
This increase, driven largely by higher enrollment and utilization during and after the pandemic, amounts to nearly 40% growth within a few years.
Major federal budget changes under the Trump administration included proposals that would reduce federal Medicaid dollars and change program requirements. The “One Big Beautiful Bill Act,” signed in 2025, is expected to cut federal Medicaid spending by over $1 trillion over 10 years, and implement work requirements and greater cost-sharing, which could limit coverage and reduce funding for some Medicaid members. These measures may shift costs to states and slow federal Medicaid growth, while the program continues to cover tens of millions nationally.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $15,841 | 14.3% |
| 2021 | $20,949 | 32.2% |
| 2022 | $21,709 | 3.6% |
| 2023 | $281,823 | 1198.2% |
| 2024 | $354,490 | 25.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $851,653 | 42.9% |
| 2 | Medicine Services and Procedures | $354,490 | 17.9% |
| 3 | National Codes Established for State Medicaid Agencies | $334,308 | 16.9% |
| 4 | Evaluation and Management | $314,581 | 15.9% |
| 5 | Procedures / Professional Services | $125,495 | 6.3% |
| 6 | Vision Services | $2,748 | 0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90837 | Psytx w pt 60 minutes | $225,576 | 10 |
| 90834 | Psytx w pt 45 minutes | $58,666 | 8 |
| 90847 | Family psytx w/pt 50 min | $56,245 | 7 |
| 90791 | Psych diagnostic evaluation | $5,713 | 4 |
| 92012 | Intrm oph exam est patient | $2,882 | 4 |
| 92340 | Fit spectacles monofocal | $2,466 | 5 |
| 92004 | Compre oph exam new pt 1/> | $1,084 | 2 |
| 92015 | Determine refractive state | $1,039 | 4 |
| 92014 | Compre oph exam est pt 1/> | $433 | 1 |
| 92341 | Fit spectacles bifocal | $381 | 1 |
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.
