San Jose Medicaid payments for Medicine Services and Procedures reach $51.8 million in 2024

In 2024, San Jose Medicaid providers billed a total of $51,781,460 for Medicine Services and Procedures, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 32.4% rise compared to 2023, when providers filed $39,108,737 in claims for this service category.

Medicaid, a public insurance program, is administered by states and receives joint funding from federal and state governments. The program serves low-income families and individuals, seniors, children, and people with disabilities, and makes up a key segment of the U.S. health care system.

Because Medicaid is funded by taxpayers, fluctuations in local billing reflect how health care resources are distributed within a community.

The Medicine Services and Procedures category groups Medicaid services based on the type of care using standardized HCPCS and CPT codes. This analysis assigned each billing code to a specific care category with uniform prefixes and numeric code ranges, ensuring related services are grouped appropriately and preventing duplication in totals and rankings.

Across different service areas in San Jose, Medicaid spending increased, with Medicine Services and Procedures ranking third in total Medicaid payments for 2024.

Statewide in California, the Medicine Services and Procedures category also held the third position by total Medicaid payments in 2024.

Reviewing the prior five years, Medicaid payments in San Jose for Medicine Services and Procedures rose by $41,335,273, or 395.7%. Growth in spending was particularly notable during certain years, with significant year-over-year jumps in both 2023 and 2021.

Although payments for Medicine Services and Procedures were dispersed throughout San Jose, a few ZIP codes saw a majority of billings. In 2024, ZIP code 95128 led with $38,638,724, followed by 95113 at $2,636,520 and 95131 with $2,398,009. These top 3 ZIP codes collectively represented 84.3% of all Medicaid payments in this category for San Jose during the year.

A small set of individual billing codes also accounted for a large share of the Medicaid payments within the Medicine Services and Procedures category.

For reference, between 2024 and 2023, San Jose’s Medicaid payments under Medicine Services and Procedures grew 32.4%, while Medicaid claims across all service categories in the city increased by 21.4% in the same timeframe.

According to the Centers for Medicare & Medicaid Services, states and the federal government together spent about $871.7 billion on Medicaid in fiscal year 2023, making up roughly 18% of all U.S. health expenditures—a sharp increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This change amounts to an approximate 40% increase in just a few years, largely influenced by greater enrollment and higher utilization during and after the pandemic.

Recent federal budget measures from the Trump administration have included plans to decrease federal Medicaid funding and restructure the program. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid spending by over $1 trillion over the next decade and bring new requirements like mandatory work and higher cost-sharing, which could impact coverage and funding for certain enrollees. These adjustments are projected to transfer more expenses to states, slowing the expansion of federal Medicaid support, although the program will still serve tens of millions of Americans.

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.