Milpitas Medicaid providers billed $8.3M under National Codes Established for State Medicaid Agencies in 2024

Providers in Milpitas billed $8,302,344 to Medicaid in 2024 for services in the National Codes Established for State Medicaid Agencies group, as shown in data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a rise of 2.5% from 2023, when $8,102,053 in claims were submitted for the same service category.

Medicaid is a government health insurance program jointly funded by federal and state governments and administered by the states. It serves low-income residents, seniors, children, and people with disabilities, making it one of the core components of the U.S. health care landscape. Additional details are available at this link.

Fluctuations in local Medicaid billing reflect how taxpayer-funded health dollars are distributed within communities.

The “National Codes Established for State Medicaid Agencies” category refers to a defined set of Medicaid-covered services organized by the specific care type and aligned by HCPCS and CPT code groupings. Each billing code for this analysis was assigned to a specific service category using consistent prefixes and numeric parameters, grouping related services, minimizing double counting, and supporting trend ranking comparisons over time.

For 2024, the National Codes Established for State Medicaid Agencies topped all Medicaid service categories in overall billing amount in Milpitas.

Similarly, across California in 2024, it was the leading Medicaid category in terms of total payments.

From the five-year period ending in 2024, Medicaid payments in Milpitas for services within the National Codes Established for State Medicaid Agencies group rose by $3,120,383, or 60.2%. Notably, significant year-over-year growth occurred in 2021 and 2023.

Though payments for this category were distributed citywide, most were concentrated within specific ZIP codes. In 2024, ZIP code 95035 accounted for the entire $8,302,344, or 100% of Milpitas’ Medicaid spending in this classification.

Medicaid funds dedicated to the National Codes Established for State Medicaid Agencies were also centered on a select set of billing codes in 2024.

To compare with broader Medicaid spending in the city, payments for the National Codes Established for State Medicaid Agencies category increased 2.5% from 2023 to 2024, while all Medicaid claim categories in Milpitas experienced an 11.7% shift during the same period.

Centers for Medicare & Medicaid Services data show combined federal and state Medicaid outlays totaled about $871.7 billion in fiscal 2023—roughly 18% of nationwide health expenditures. This was a significant climb from $613.5 billion in 2019, before COVID-19 emerged.

This rise, about 40%, is attributed largely to increased enrollment and utilization stemming from the pandemic and its aftermath.

Congressional budget legislation from the Trump administration included major proposals affecting federal Medicaid financing and program structure. One example, the “One Big Beautiful Bill Act,” enacted in 2025, is projected to reduce federal Medicaid spending by more than $1 trillion over 10 years. It also imposes work requirements and greater cost sharing, which may reduce both coverage and federal support for some groups, placing more of the fiscal burden on individual states even as the program remains a central part of health coverage for millions.

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.