Poway Medicaid spending on national codes category climbs 35% to $5,336,957 in 2024

In 2024, Medicaid providers in Poway billed $5,336,957 for services classified under the National Codes Established for State Medicaid Agencies category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. That figure represents a 34.7% increase compared to 2023, which saw $3,962,813 in provider claims for the same service type.

Medicaid, a public health insurance initiative managed by states and funded through federal and state resources, offers coverage to people with low incomes, as well as seniors, children, and those with disabilities. It stands as one of the major segments of U.S. health care.

Because Medicaid funding comes from taxpayers, fluctuations in local claims signal shifts in the allocation of community health care funding.

The “National Codes Established for State Medicaid Agencies” category encompasses a selection of Medicaid-billed services grouped by care type, based on standardized HCPCS and CPT code sets. To allow for grouping of similar services, each billing code was attributed to only one service category using established prefixes and number ranges, delivering consistent categorizations without double counting and ensuring accurate historical rankings.

Although there was growth in Medicaid spending in several service categories, National Codes Established for State Medicaid Agencies took the top spot for total Medicaid payments in Poway in 2024.

Across California, the National Codes Established for State Medicaid Agencies category also ranked first for Medicaid payments in 2024.

Over the five years prior to 2024, Medicaid payments tied to the National Codes Established for State Medicaid Agencies category in Poway rose by $1,927,175, a 56.5% increase. Growth in expenditure was stronger during certain stretches, with peak increases registered in 2020 and 2021.

Spending in the National Codes Established for State Medicaid Agencies category was citywide, but payments were largest in just a few ZIP codes. In 2024, ZIP code 92064 accounted for $5,336,956 of these Medicaid transactions. This single ZIP code represented 100% of payments for the category in Poway during the year.

Within this category, Medicaid outlays were mainly concentrated in a small group of individual billing codes.

For additional context, Medicaid payments for this category in Poway climbed 34.7% between 2024 and 2023, while overall Medicaid spending in all categories in the city saw a 6.5% period-over-period change.

The Centers for Medicare & Medicaid Services report total federal and state Medicaid spending was about $871.7 billion in fiscal year 2023, equal to approximately 18% of all national health expenditures. This was a marked increase from around $613.5 billion in 2019, prior to the COVID-19 pandemic.

This growth amounts to about 40% over just a few years, largely attributable to rising enrollment and increased usage during and in the aftermath of the pandemic years.

Past federal budget actions during the Trump administration proposed large reductions to federal Medicaid aid and restructuring of the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is set to cut more than $1 trillion in federal Medicaid expenditures over the coming decade. The legislation introduces measures such as work requirements and higher cost-sharing, likely limiting some coverage and federal funding, thereby shifting more payment responsibility to states even as the program serves 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.