Santa Clara Medicaid payments for Medicine Services and Procedures reach $1.6 million in 2024

In 2024, Medicaid providers in Santa Clara submitted $1,602,930 in claims for services under the Medicine Services and Procedures category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 169.3% rise from 2023, when providers billed $595,208 for the same category of service.

Medicaid is a public insurance initiative administered by states with joint federal and state funding. The program serves low-income individuals and families, seniors, children, and people with disabilities, making it a significant component of the U.S. health care system.

Changes in Medicaid payment levels reflect how public health care resources are distributed within local communities, as funding is sourced from taxpayers.

The “Medicine Services and Procedures” category encompasses a variety of Medicaid-billed services organized by care type, based on standardized HCPCS and CPT codes. For this report, each billing code was grouped into a single service category using established code prefixes and number ranges to support group analysis while ensuring services were not counted more than once and rankings remained accurate across years.

Medicine Services and Procedures received the highest total Medicaid payments among all service categories in Santa Clara during 2024, outpacing other categories as spending increased broadly.

For 2024 statewide in Utah, Medicine Services and Procedures also ranked first by total Medicaid payments.

Looking over a five-year span through 2024, Medicaid payments in Santa Clara linked to Medicine Services and Procedures rose by $1,602,930, equating to 0%. The rate of increase accelerated during certain years, notably in 2023 and 2022.

Spending within the Medicine Services and Procedures category was distributed throughout Santa Clara, but payments were focused primarily in a few ZIP codes. In 2024, ZIP code 84765 saw the highest payments in this category, with $1,602,930. This single ZIP code accounted for all Medicaid payments for Medicine Services and Procedures in Santa Clara that year.

Payments in this service category also centered on a small number of specific billing codes.

Comparing categories, Santa Clara’s Medicaid payments related to Medicine Services and Procedures jumped 169.3% between 2024 and 2023, while all Medicaid claims in the city increased by 179.4% during the same time frame.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures totaled approximately $871.7 billion in fiscal year 2023, making up about 18% of total national health spending and up substantially from $613.5 billion in 2019, before the COVID-19 pandemic.

This growth amounts to around 40% over several years, largely spurred by expanded enrollment and greater usage during and following the pandemic period.

Recent federal budget measures approved during the Trump administration included significant plans to reduce federal Medicaid funding and reshape its structure. The “One Big Beautiful Bill Act,” passed in 2025, is forecast to cut more than $1 trillion from federal Medicaid spending over the next decade. It institutes policies like work requirements and higher cost-sharing, which could limit funding and coverage for some enrollees. These changes are likely to increase states’ fiscal responsibility and restrain growth in the federal share for Medicaid, despite the program continuing to assist 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.