According to the U.S. Department of Health and Human Services Medicaid Provider Spending database, Medicaid providers in Costa Mesa submitted $7,149,143 in claims for services within the National Codes Established for State Medicaid Agencies category in 2024. This represented a 293.1% rise from the $1,818,622 in claims reported in 2023 for the same category.
Medicaid is a state-operated, jointly federal- and state-funded public health insurance program. It provides coverage for low-income individuals and families, children, seniors, and people with disabilities, making it a cornerstone of the U.S. health care system. For an overview of Medicaid funding, see this resource.
Since Medicaid relies on taxpayer funding, fluctuations in local billing levels illustrate the ways in which public health care money is spent within the community.
The “National Codes Established for State Medicaid Agencies” category encompasses Medicaid-billed services grouped by standardized HCPCS and CPT code prefixes and ranges, assigned for this analysis to one service category to prevent double counting and maintain accurate trend and ranking data.
While growth in Medicaid spending was observed in multiple categories, National Codes Established for State Medicaid Agencies was the fourth-largest by total Medicaid payments in Costa Mesa for 2024.
Across California, this category saw the highest total Medicaid payments statewide in 2024.
For the five-year period ending in 2024, Medicaid payments in Costa Mesa tied to the National Codes Established for State Medicaid Agencies increased by $5,874,939—a 461.1% gain. The most marked annual increases were observed in 2021 and 2023, when payment growth accelerated.
Citywide spending for this category was largely focused within a small number of ZIP codes. In 2024, ZIP code 92627 reported $7,109,259 and ZIP code 92626 recorded $39,883 in Medicaid payments. Combined, these 2 ZIP codes accounted for 100% of the year’s Medicaid payments within this category in Costa Mesa.
A small subset of individual billing codes was responsible for most of the Medicaid spending in this category.
Between 2023 and 2024, Costa Mesa’s Medicaid payments for the National Codes Established for State Medicaid Agencies category jumped 293.1%, compared to a 69.5% rate of increase across all Medicaid claim types locally during the same period.
According to the Centers for Medicare & Medicaid Services, nationwide Medicaid spending—state and federal funding combined—reached about $871.7 billion in fiscal 2023, accounting for 18% of all U.S. health expenditures and representing substantial growth from roughly $613.5 billion in 2019 before the COVID-19 pandemic.
That $258.2 billion growth in a few years reflects a 40% increase, spurred largely by expanded enrollment and greater utilization during and after the pandemic.
Federal budgets enacted under the Trump administration introduced sweeping changes to Medicaid, including major proposed reductions to federal funding and program restructuring. The “One Big Beautiful Bill Act,” became law in 2025, instituting measures projected to reduce federal Medicaid outlays by more than $1 trillion over 10 years and impose work requirements and higher cost-sharing, which could affect coverage and state-level costs as federal growth is restrained despite the program’s reach.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,274,204 | -8.2% |
| 2021 | $2,266,475 | 77.9% |
| 2022 | $1,768,014 | -22% |
| 2023 | $1,818,622 | 2.9% |
| 2024 | $7,149,142 | 293.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $47,969,927 | 59.4% |
| 2 | Evaluation and Management | $8,721,725 | 10.8% |
| 3 | Alcohol and Drug Abuse Treatment | $8,690,690 | 10.8% |
| 4 | National Codes Established for State Medicaid Agencies | $7,149,142 | 8.9% |
| 5 | Medicine Services and Procedures | $3,957,176 | 4.9% |
| 6 | Pathology and Laboratory Procedures | $1,729,550 | 2.1% |
| 7 | Dental Services | $1,366,575 | 1.7% |
| 8 | Ambulance and Other Transport Services and Supplies | $686,283 | 0.8% |
| 9 | Procedures / Professional Services | $135,953 | 0.2% |
| 10 | Anesthesia | $132,436 | 0.2% |
| 11 | Drugs Administered Other than Oral Method | $114,169 | 0.1% |
| 12 | Surgery | $48,132 | 0.1% |
| 13 | Radiology Procedures | $28,225 | <0.1% |
| 14 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $23,282 | <0.1% |
| 15 | Medical And Surgical Supplies | $7,620 | <0.1% |
| 16 | Orthotic Procedures and services | $2,653 | <0.1% |
| 17 | Administrative, Miscellaneous and Investigational | $791 | <0.1% |
| 18 | Durable Medical Equipment | $761 | <0.1% |
| 19 | Temporary Codes | $727 | <0.1% |
| 20 | Vision Services | $364 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $7,109,259 | 92 |
| T1001 | Nursing assessment/evaluatn | $39,883 | 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.
