In 2024, Medicaid providers in Watsonville reported $28,029,366 in billings for services grouped under the National Codes Established for State Medicaid Agencies, according to figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 0.8% rise over the previous year, when billings for these services totaled $27,803,855.
Medicaid is a state-administered public insurance program with funding shared between state and federal governments. Serving low-income families, older adults, children, and those with disabilities, the program is a significant part of the nation’s health care framework.
Since Medicaid funding is sourced from taxation, fluctuations in local billing provide insight into how health care spending is distributed within a community.
The “National Codes Established for State Medicaid Agencies” category encompasses a specific set of Medicaid-billed services, each defined by care type and grouped based on standardized HCPCS and CPT code systems. For this study, billing codes were mapped to unique service categories using an approach consistent with code prefixes and number ranges, supporting analysis by keeping related services together and ensuring no double counting occurs when tracking changes over time.
While Medicaid payments increased in several service categories, National Codes Established for State Medicaid Agencies was the top-ranked category in Watsonville for total Medicaid outlays in 2024.
Across California, the National Codes Established for State Medicaid Agencies service group also held the highest statewide Medicaid payment total for 2024.
Between 2020 and 2024, Watsonville saw Medicaid payments for the National Codes Established for State Medicaid Agencies category grow by $3,546,735, a 14.5% increase. Periods of especially strong year-over-year growth were observed in 2023 and 2021.
Payments in this category were dispersed throughout Watsonville but were heavily concentrated in select ZIP codes. In 2024, ZIP code 95076 accounted for the entirety of Medicaid payments for the National Codes Established for State Medicaid Agencies category, amounting to $28,029,366. As a result, just 1 ZIP code represented 100% of the category’s Medicaid billings in the city that year.
Within this service group, Medicaid expenditures focused primarily on a limited set of billing codes.
For context, while Medicaid payments tied to this category in Watsonville grew by 0.8% from 2023 to 2024, all Medicaid claim categories in the city saw a combined change of 3% over the same time frame.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending reached about $871.7 billion during fiscal year 2023, representing approximately 18% of total U.S. health care expenses, up notably from around $613.5 billion in 2019, prior to the COVID-19 pandemic.
This reflects about 40% growth over several years, mainly due to expanded coverage and increased usage during and after the pandemic.
Recent federal budget measures during the Trump administration have featured proposals aimed at reducing federal Medicaid expenditures and restructuring its funding model. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to trim federal Medicaid outlays by more than $1 trillion over a decade, implementing policies such as employment requirements and greater cost-sharing, which could limit coverage and financial support for certain recipients. These policy changes are anticipated to increase state responsibility and curb federal Medicaid growth, even as it continues serving millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $24,482,631 | 12.2% |
| 2021 | $28,643,545 | 17% |
| 2022 | $21,170,172 | -26.1% |
| 2023 | $27,803,854 | 31.3% |
| 2024 | $28,029,366 | 0.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $28,029,366 | 54.9% |
| 2 | Evaluation and Management | $6,279,983 | 12.3% |
| 3 | Medicine Services and Procedures | $5,339,209 | 10.5% |
| 4 | Temporary National Codes (Non-Medicare) | $4,639,148 | 9.1% |
| 5 | Radiology Procedures | $2,123,307 | 4.2% |
| 6 | Dental Services | $1,268,256 | 2.5% |
| 7 | Pathology and Laboratory Procedures | $892,226 | 1.7% |
| 8 | Alcohol and Drug Abuse Treatment | $798,965 | 1.6% |
| 9 | Procedures / Professional Services | $441,140 | 0.9% |
| 10 | Surgery | $404,980 | 0.8% |
| 11 | Ambulance and Other Transport Services and Supplies | $192,969 | 0.4% |
| 12 | Coronavirus Diagnostic Panel | $153,940 | 0.3% |
| 13 | Medical And Surgical Supplies | $127,875 | 0.3% |
| 14 | Durable Medical Equipment | $114,414 | 0.2% |
| 15 | Drugs Administered Other than Oral Method | $103,700 | 0.2% |
| 16 | Orthotic Procedures and services | $32,871 | 0.1% |
| 17 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $29,275 | 0.1% |
| 18 | Vision Services | $29,248 | 0.1% |
| 19 | Hearing Services | $27,673 | 0.1% |
| 20 | Temporary Codes | $23,135 | <0.1% |
| 21 | Anesthesia | $347 | <0.1% |
| 22 | Administrative, Miscellaneous and Investigational | $90 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $27,833,176 | 837 |
| T4541 | Large disposable underpad | $37,318 | 10 |
| T4526 | Adult size pull-on med | $36,567 | 10 |
| T4527 | Adult size pull-on lg | $29,929 | 10 |
| T4535 | Disposable liner/shield/pad | $25,790 | 10 |
| T1999 | Noc retail items andsupplies | $25,203 | 25 |
| T4528 | Adult size pull-on xl | $17,766 | 10 |
| T1001 | Nursing assessment/evaluatn | $8,219 | 5 |
| T2003 | N-et; encounter/trip | $7,054 | 4 |
| T5999 | Supply, nos | $4,791 | 8 |
| T1014 | Telehealth transmit, per min | $2,565 | 6 |
| T1027 | Family training & counseling | $983 | 9 |
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.
