Carlsbad Medicaid providers billed $3,343,735 for services under the Procedures / Professional Services category in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This amount rose by 138.3% compared with the previous year, when claims for this service category totaled $1,403,127.
Medicaid, administered by the states and financed through joint federal and state funding, provides coverage to low-income people, older adults, children, and individuals with disabilities, making it a core component of the U.S. health care system.
Because Medicaid spending is taxpayer-funded, adjustments in local payments indicate how community health care resources are allocated.
The Procedures / Professional Services category includes a range of billing codes grouped by care type, using standardized HCPCS and CPT prefixes and numbers. For this analysis, each code was placed in a single category using fixed prefixes and numeric ranges to analyze related services together and prevent double counting, keeping service rankings consistent over time.
Although there was an overall increase in several Medicaid service categories, Procedures / Professional Services was the fifth-largest category by total Medicaid payments in Carlsbad in 2024.
At the state level, Procedures / Professional Services was the sixth-ranked Medicaid payment category in California for 2024.
Between 2019 and 2024, Medicaid payments for Procedures / Professional Services in Carlsbad grew by $2,367,195, or 242.4%. Growth rates accelerated at specific points, with significant year-over-year gains noted for 2020 and 2023.
Payments across the Procedures / Professional Services category were concentrated in just a few ZIP codes within Carlsbad. In 2024, the ZIP codes with the highest Medicaid spending for this category were 92010 with $2,117,442, 92009 at $976,771, and 92011 with $177,418. Combined, these top 3 ZIP codes accounted for 97.8% of all such Medicaid payments in the city for the year.
Spending in the Procedures / Professional Services category was also aggregated in a small number of billing codes.
For comparison, Carlsbad experienced a 138.3% rise in Medicaid payments for Procedures / Professional Services between 2023 and 2024, while all Medicaid claim categories collectively saw a 3.4% change in the city for the same period.
According to the Centers for Medicare & Medicaid Services, joint federal and state spending on Medicaid amounted to about $871.7 billion in fiscal year 2023. This equaled around 18% of all national health care expenditures, increasing sharply from about $613.5 billion in 2019, prior to the COVID-19 pandemic.
This marks an increase of approximately 40% over a few years, largely attributed to expanded enrollment and greater usage during and after the pandemic.
Federal budget legislation during the Trump administration has put forward several proposals to reduce federal Medicaid funding and alter the program’s framework. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is forecasted to cut more than $1 trillion from federal Medicaid funding over a decade. The law introduces policies, including work requirements and higher cost-sharing, which could curb funding or coverage for some enrollees. These adjustments could result in additional state responsibility and limit the pace of federal Medicaid support increase as the program continues serving millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $976,540 | 9790.3% |
| 2021 | $1,082,284 | 10.8% |
| 2022 | $998,790 | -7.7% |
| 2023 | $1,403,126 | 40.5% |
| 2024 | $3,343,735 | 138.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Orthotic Procedures and services | $23,474,668 | 31% |
| 2 | Medical And Surgical Supplies | $16,168,213 | 21.4% |
| 3 | Durable Medical Equipment | $13,160,801 | 17.4% |
| 4 | National Codes Established for State Medicaid Agencies | $8,204,161 | 10.8% |
| 5 | Procedures / Professional Services | $3,343,735 | 4.4% |
| 6 | Medicine Services and Procedures | $2,291,341 | 3% |
| 7 | Alcohol and Drug Abuse Treatment | $2,141,123 | 2.8% |
| 8 | Administrative, Miscellaneous and Investigational | $2,077,747 | 2.7% |
| 9 | Evaluation and Management | $1,280,381 | 1.7% |
| 10 | Drugs Administered Other than Oral Method | $1,109,041 | 1.5% |
| 11 | Temporary National Codes (Non-Medicare) | $969,391 | 1.3% |
| 12 | Ambulance and Other Transport Services and Supplies | $572,718 | 0.8% |
| 13 | Surgery | $396,918 | 0.5% |
| 14 | Pathology and Laboratory Procedures | $197,088 | 0.3% |
| 15 | Radiology Procedures | $129,442 | 0.2% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $48,677 | 0.1% |
| 17 | Temporary Codes | $47,379 | 0.1% |
| 18 | Dental Services | $32,010 | <0.1% |
| 19 | Vision Services | $12,279 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G9012 | Other specified case mgmt | $3,049,409 | 23 |
| G0300 | Hhs/hospice of lpn ea 15 min | $179,575 | 8 |
| G9008 | Mccd,phys coor-care ovrsght | $44,804 | 5 |
| G0151 | Hhcp-serv of pt,ea 15 min | $44,225 | 10 |
| G0299 | Hhs/hospice of rn ea 15 min | $14,275 | 8 |
| G0152 | Hhcp-serv of ot,ea 15 min | $5,830 | 7 |
| G0333 | Dispense fee initial 30 day | $2,555 | 11 |
| G2211 | Complex e/m visit add on | $1,841 | 10 |
| G9920 | Scrning perf and negative | $1,218 | 13 |
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.
