Newport Beach Medicaid providers submitted $6,252,399 in claims for Medicine Services and Procedures in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This represented a 43.9% rise from the $4,345,026 billed for similar services in 2023.
Medicaid, a state-run health insurance program with joint federal and state funding, covers low-income residents, seniors, children, and individuals with disabilities. As a result, it forms one of the largest components of the U.S. health system.
Since Medicaid relies on taxpayer contributions, shifts in community-level billing patterns provide insight into the allocation of public health dollars.
The “Medicine Services and Procedures” category encompasses Medicaid-reimbursed care organized by service type, using standardized HCPCS and CPT coding structures. Each billing code for this analysis is assigned to a single service grouping through code prefixes and number ranges. This methodology helps avoid double counting and maintains consistency for trend and ranking comparisons over time.
Spending in the Medicine Services and Procedures category was one of the largest among all Medicaid payment types in Newport Beach in 2024, placing third overall.
Statewide in California, the Medicine Services and Procedures category also ranked third for total Medicaid payments in 2024.
From 2019 to 2024, Newport Beach saw a $4,830,704 (339.8%) increase in Medicaid spending for Medicine Services and Procedures. Accelerated growth was observed in 2023 and 2022, with sharp year-over-year increases.
Spending under this category in 2024 was concentrated within a few local ZIP codes. Contributions included $5,492,098 from 92660, $756,855 from 92663, and $3,445 from 92662. Collectively, these top 3 ZIP codes made up 100% of the Medicine Services and Procedures Medicaid payments in Newport Beach for the year.
The distribution of Medicaid payments in this category was further concentrated among a small number of billing codes.
Comparing the 43.9% growth between 2023 and 2024 in local Medicine Services and Procedures claims, all Medicaid claim categories in Newport Beach rose by 19.8% over the same span.
According to the Centers for Medicare & Medicaid Services, Medicaid spending from federal and state sources totaled around $871.7 billion in fiscal 2023, accounting for about 18% of all health care expenditures, a sharp rise from $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This increase, about 40% in several years, has been fueled mainly by higher enrollment and greater use of services during and after the pandemic.
Recent congressional budget actions during the Trump administration have included major proposals to reduce federal Medicaid spending and restructure the program. The “One Big Beautiful Bill Act,” made law in 2025, is expected to reduce federal Medicaid outlays by over $1 trillion over the next 10 years and implements new work requirements and higher cost-sharing that could restrict coverage and funding for some recipients. These changes are anticipated to increase state liabilities and limit federal Medicaid expansion, despite the continued service of tens of millions of Americans by the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,421,695 | 0.1% |
| 2021 | $1,762,587 | 24% |
| 2022 | $2,364,519 | 34.2% |
| 2023 | $4,345,026 | 83.8% |
| 2024 | $6,252,399 | 43.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $13,194,103 | 37.7% |
| 2 | Alcohol and Drug Abuse Treatment | $8,026,898 | 23% |
| 3 | Medicine Services and Procedures | $6,252,399 | 17.9% |
| 4 | Pathology and Laboratory Procedures | $2,349,148 | 6.7% |
| 5 | National Codes Established for State Medicaid Agencies | $1,424,349 | 4.1% |
| 6 | Anesthesia | $1,278,806 | 3.7% |
| 7 | Surgery | $801,177 | 2.3% |
| 8 | Radiology Procedures | $668,389 | 1.9% |
| 9 | Ambulance and Other Transport Services and Supplies | $444,953 | 1.3% |
| 10 | Dental Services | $219,501 | 0.6% |
| 11 | Procedures / Professional Services | $190,053 | 0.5% |
| 12 | Drugs Administered Other than Oral Method | $74,475 | 0.2% |
| 13 | Temporary National Codes (Non-Medicare) | $41,971 | 0.1% |
| 14 | Vision Services | $77 | <0.1% |
| 15 | Outpatient PPS | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90837 | Psytx w pt 60 minutes | $2,197,099 | 140 |
| 90834 | Psytx w pt 45 minutes | $511,794 | 88 |
| 96113 | Devel tst phys/qhp ea addl | $405,326 | 24 |
| 96156 | Hlth bhv assmt/reassessment | $393,007 | 91 |
| 96110 | Developmental screen w/score | $345,923 | 158 |
| 90833 | Psytx w pt w e/m 30 min | $331,425 | 65 |
| 90791 | Psych diagnostic evaluation | $249,784 | 63 |
| 92587 | Evoked auditory test limited | $204,776 | 83 |
| 90836 | Psytx w pt w e/m 45 min | $116,219 | 31 |
| 96137 | Psycl/nrpsyc tst phy/qhp ea | $95,358 | 13 |
| 96112 | Devel tst phys/qhp 1st hr | $91,060 | 24 |
| 90846 | Family psytx w/o pt 50 min | $75,808 | 26 |
| 96374 | Ther/proph/diag inj iv push | $68,850 | 47 |
| 96131 | Psycl tst eval phys/qhp ea | $68,639 | 13 |
| 93005 | Electrocardiogram tracing | $64,587 | 137 |
| 93010 | Electrocardiogram report | $62,758 | 278 |
| 95018 | All tstg perq&iq drugs/biol | $61,140 | 11 |
| 90999 | Unlisted dialysis procedure | $56,932 | 2 |
| 92551 | Pure tone hearing test air | $56,260 | 122 |
| 90785 | Psytx complex interactive | $51,683 | 85 |
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.
