In 2024, Medicaid providers in Arroyo Grande billed $4,524,957 for services categorized under the National Codes Established for State Medicaid Agencies, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This total marks a 4.6% rise from 2023, when claims for the same category amounted to $4,324,154.
Medicaid operates as a public health insurance option administered by each state and financed collectively by federal and state governments. The program covers eligible low-income individuals and families, senior citizens, children, and those with disabilities, remaining one of the largest elements of the U.S. health care infrastructure.
As taxpayer dollars support Medicaid, fluctuations in local billing demonstrate how public health care funding is distributed across the community.
The National Codes Established for State Medicaid Agencies category identifies a collection of services billed under Medicaid by service type, as defined through standard HCPCS and CPT code groupings. In this analysis, each billing code was allocated to a specific service category using consistent code prefixes and numbering to ensure related services are tracked together and to prevent duplicate counts when ranking services over time.
Medicaid expenditures rose across several categories, but National Codes Established for State Medicaid Agencies maintained the top spot in Arroyo Grande by total Medicaid payments during 2024.
Statewide in California, the National Codes Established for State Medicaid Agencies category also ranked first for total Medicaid spending in 2024.
Between 2019 and 2024, Medicaid payments tied to the National Codes Established for State Medicaid Agencies category in Arroyo Grande went up by $1,184,717, or 35.5%. Certain periods saw faster growth, with significant year-over-year gains in both 2020 and 2023.
Although these expenditures were distributed throughout Arroyo Grande, most payments were concentrated in a few ZIP codes. For 2024, the highest amounts came from ZIP code 93420, which totaled $4,524,957. Overall, this ZIP code represented 100% of Medicaid payments in this service category citywide for the year.
Medicaid spending within the National Codes Established for State Medicaid Agencies was also concentrated among select billing codes.
For context, Arroyo Grande’s Medicaid payments for the category increased 4.6% from 2023 to 2024. By comparison, Medicaid payments across all claim types in the city rose by 14.4% in the same timeframe.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal 2023, accounting for about 18% of the nation’s health care spending. This reflects a substantial increase from roughly $613.5 billion in 2019, prior to the COVID-19 outbreak.
This change represents a roughly 40% increase over several years, with growth influenced by expansions in enrollment and higher utilization seen throughout and after the pandemic period.
Recent federal budget actions during the Trump administration introduced proposals to scale back federal Medicaid funding and revise key elements of the program. The “One Big Beautiful Bill Act,” enacted in 2025, is forecast to reduce federal Medicaid spending by more than $1 trillion over the coming decade. It incorporates new measures—including work requirements and increased cost-sharing—that may affect coverage and financial support for some enrollees. These policies are projected to increase the financial burden on states and limit federal Medicaid growth even while serving tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $3,340,239 | 43% |
| 2021 | $3,959,176 | 18.5% |
| 2022 | $3,405,910 | -14% |
| 2023 | $4,324,154 | 27% |
| 2024 | $4,524,957 | 4.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $4,524,957 | 53.3% |
| 2 | Evaluation and Management | $1,945,433 | 22.9% |
| 3 | Medicine Services and Procedures | $969,955 | 11.4% |
| 4 | Durable Medical Equipment | $352,696 | 4.2% |
| 5 | Alcohol and Drug Abuse Treatment | $230,515 | 2.7% |
| 6 | Anesthesia | $124,644 | 1.5% |
| 7 | Medical And Surgical Supplies | $102,085 | 1.2% |
| 8 | Procedures / Professional Services | $80,253 | 0.9% |
| 9 | Dental Services | $46,561 | 0.5% |
| 10 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $35,788 | 0.4% |
| 11 | Vision Services | $34,842 | 0.4% |
| 12 | Surgery | $18,981 | 0.2% |
| 13 | Orthotic Procedures and services | $9,541 | 0.1% |
| 14 | Radiology Procedures | $4,752 | 0.1% |
| 15 | Pathology and Laboratory Procedures | $4,581 | 0.1% |
| 16 | Temporary National Codes (Non-Medicare) | $2,717 | <0.1% |
| 17 | Temporary Codes | $911 | <0.1% |
| 18 | Drugs Administered Other than Oral Method | $106 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $4,304,512 | 131 |
| T1017 | Targeted case management | $147,854 | 11 |
| T2024 | Serv asmnt/care plan waiver | $33,399 | 3 |
| T1001 | Nursing assessment/evaluatn | $16,191 | 8 |
| T2021 | Day habil waiver per 15 min | $14,519 | 2 |
| T4541 | Large disposable underpad | $5,743 | 3 |
| T4522 | Adult size brief/diaper med | $1,424 | 1 |
| T4535 | Disposable liner/shield/pad | $1,309 | 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.
