Providers in Pismo Beach billed Medicaid $526,410 for Medicine Services and Procedures in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That figure represents a 6.8% rise from 2023, when $493,040 in claims were recorded for this service category.
Medicaid, a state-operated and federally funded public health insurance program, supports low-income individuals, families, seniors, children, and people with disabilities, making it a significant part of the U.S. health care system. More information on Medicaid funding is available here.
Because Medicaid spending is sourced from taxpayer funds, fluctuations in local billing levels highlight how community resources are distributed through public health care.
The “Medicine Services and Procedures” group encompasses a range of Medicaid-billed treatments, categorized by specific care types and standardized HCPCS and CPT codes. Billing was analyzed by assigning codes to service categories using consistent prefixes and numeric ranges, helping ensure accuracy in rankings and avoid double counting across years.
Although overall Medicaid outlays grew in several service areas, Medicine Services and Procedures represented the largest payment total in Pismo Beach for 2024.
Statewide in California, the Medicine Services and Procedures category ranked third by total Medicaid payment during 2024.
Between 2019 and 2024, Medicaid payments for Medicine Services and Procedures rose by $493,220—an increase of 1486%. The rate of growth quickened in certain periods, with notable year-over-year surges in 2023 and 2022.
While payments were made citywide, the majority were attributed to a small number of ZIP codes. In 2024, ZIP code 93449 alone accounted for $526,409 in these Medicaid payments. The top ZIP code was responsible for 100% of all Medicine Services and Procedures category Medicaid payments in Pismo Beach during the year.
Within this category, most Medicaid dollars were linked to select billing codes.
For perspective, Medicaid spending on Medicine Services and Procedures in Pismo Beach was up 6.8% from 2023 to 2024, compared with a 9.5% overall increase across all Medicaid claim categories locally in the same timeframe.
Centers for Medicare & Medicaid Services data shows that total federal and state Medicaid spending hit approximately $871.7 billion in fiscal year 2023, accounting for around 18% of the nation’s health expenditures, up from $613.5 billion in 2019, before the COVID-19 pandemic.
This growth—roughly a 40% rise in a span of several years—was primarily driven by increased enrollment and higher service use during and following the pandemic.
Major federal budget changes passed under the Trump administration proposed and enacted significant reductions to federal Medicaid support. The “One Big Beautiful Bill Act,” signed in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next decade and introduces new policies like work requirements and expanded cost-sharing. These measures could affect funding levels and coverage for some recipients, prompting states to shoulder a greater financial share while participation in the program remains high.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $33,190 | -46.7% |
| 2021 | $57,437 | 73.1% |
| 2022 | $152,491 | 165.5% |
| 2023 | $493,040 | 223.3% |
| 2024 | $526,409 | 6.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $526,409 | 27.9% |
| 2 | Surgery | $444,119 | 23.6% |
| 3 | Dental Services | $364,651 | 19.4% |
| 4 | Alcohol and Drug Abuse Treatment | $342,801 | 18.2% |
| 5 | Evaluation and Management | $130,760 | 6.9% |
| 6 | Temporary National Codes (Non-Medicare) | $60,074 | 3.2% |
| 7 | Anesthesia | $10,859 | 0.6% |
| 8 | Pathology and Laboratory Procedures | $1,928 | 0.1% |
| 9 | Procedures / Professional Services | $1,240 | 0.1% |
| 10 | Medical And Surgical Supplies | $1,205 | 0.1% |
| 11 | Drugs Administered Other than Oral Method | $337 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90837 | Psytx w pt 60 minutes | $387,765 | 8 |
| 97140 | Manual therapy 1/> regions | $28,473 | 13 |
| 93970 | Extremity study | $27,799 | 7 |
| 90999 | Unlisted dialysis procedure | $20,229 | 1 |
| 97110 | Therapeutic exercises | $19,892 | 14 |
| 90791 | Psych diagnostic evaluation | $16,450 | 6 |
| 90677 | Pcv20 vaccine im | $4,220 | 4 |
| 97035 | App mdlty 1+ultrasound ea 15 | $3,371 | 11 |
| 93923 | Upr/lxtr art stdy 3+ lvls | $3,310 | 3 |
| 92551 | Pure tone hearing test air | $2,430 | 8 |
| 97530 | Therapeutic activities | $2,034 | 7 |
| 97535 | Self care mngment training | $1,896 | 2 |
| 93925 | Lower extremity study | $1,678 | 1 |
| 90648 | Hib prp-t vaccine 4 dose im | $1,527 | 5 |
| 90656 | Iiv3 vacc no prsv 0.5 ml im | $1,050 | 4 |
| 90633 | Hepa vacc ped/adol 2 dose im | $739 | 4 |
| 90723 | Dtap-hep b-ipv vaccine im | $719 | 3 |
| 97162 | Pt eval mod complex 30 min | $609 | 1 |
| 90471 | Immunization admin | $510 | 1 |
| 90680 | Rv5 vacc 3 dose live oral | $464 | 2 |
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.
