Tustin Medicaid payments for National Codes Established for State Medicaid Agencies reach $11.1 million in 2024

Providers in Tustin billed $11,131,743 to Medicaid in 2024 for services classified under the National Codes Established for State Medicaid Agencies category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects a 3.1% rise from 2023, when billed claims in this category totaled $10,799,772.

Medicaid is a state-administered health insurance program with joint funding from federal and state governments as explained here. The program covers qualified low-income individuals and families, older adults, children, and those with disabilities, making it a key component of the nation’s health care system.

Since taxpayer dollars fund Medicaid, fluctuations in billing levels locally help show how public health funding is spent in different communities.

The “National Codes Established for State Medicaid Agencies” category encompasses a selection of Medicaid-billed services, determined by the type of care and grouped according to standardized HCPCS and CPT code sets. In this analysis, each code was assigned to one service category based on shared code prefixes and numeric patterns, ensuring related services are tracked together, rankings remain accurate over time, and double-counting is avoided.

Spending on Medicaid increased across various service categories, with the National Codes Established for State Medicaid Agencies category bringing in the highest total payments in Tustin for 2024.

Across California, this category also led the state in total Medicaid payments for the same year.

From 2019 through 2024, Medicaid payments associated with the National Codes Established for State Medicaid Agencies in Tustin rose by $4,213,874, a 60.9% increase. Certain years, such as 2021 and 2020, saw more rapid year-over-year growth during this period.

In Tustin, Medicaid spending for these services was mostly allocated to a few ZIP codes. In 2024, ZIP code 92780 recorded $10,386,133 in payments, and 92782 received $745,608; combined, these two ZIP codes represented the entirety of Medicaid payments tied to this category in the city for the year.

Within the National Codes Established for State Medicaid Agencies group, the majority of payments were linked to a small set of specific billing codes.

To compare, Medicaid payments for this category in Tustin rose by 3.1% between 2024 and 2023, while overall Medicaid claim payments across the city increased by 1.2% during the same timeframe.

The Centers for Medicare & Medicaid Services report that federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023, or about 18% of all national health expenditures. This figure is up significantly from $613.5 billion in 2019, before the onset of COVID-19.

This growth amounts to nearly 40% over several years, largely driven by expanded Medicaid enrollment and increased use of services during and following the pandemic.

Recent federal budget measures under the Trump administration have included major proposals to cut federal Medicaid funding and restructure the program. For instance, the One Big Beautiful Bill Act, enacted in 2025, is expected to reduce federal Medicaid funding by more than $1 trillion over 10 years and brings in policies such as work requirements and higher cost-sharing, possibly reducing coverage and funding for certain recipients. These changes may lead states to take on more Medicaid costs and could limit future federal funding increases, though Medicaid remains a vital resource for tens of millions nationwide.

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.