Vista Medicaid providers billed $18,802,251 for services under the National Codes Established for State Medicaid Agencies category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 10% rise from 2023, when billing for these services totaled $17,090,339.
Medicaid is administered by states and funded by both federal and state governments. It provides coverage for low-income people and families, seniors, children and individuals with disabilities, making it a core component of the U.S. health care system.
Because Medicaid funding relies on public dollars, trends in local billing reflect how community health care resources are distributed.
The “National Codes Established for State Medicaid Agencies” grouping covers certain billed Medicaid services organized by care type, based on specific code ranges and prefixes within HCPCS and CPT systems. For this review, each code was assigned to a unique service group by consistent numeric criteria. This maintained clear tallies and rankings and avoided duplicate counts across categories.
Medicaid spending increased in multiple service groups in recent years, yet National Codes Established for State Medicaid Agencies led all Vista categories by total payments in 2024.
At the statewide level, this same category was the largest by payment amount in California for the year 2024.
From 2019 through 2024, spending in Vista related to this category rose by $3,432,227, an increase of 22.3%. Notable upticks in yearly spending occurred in 2023 and 2021, reflecting periods of accelerated growth.
Payments within this category, though present across Vista, were focused in a handful of ZIP codes. In 2024, ZIP code 92084 received $14,240,640, 92083 accounted for $3,589,392, and 92081 totaled $972,218 in Medicaid spending. Collectively, these 3 ZIP codes made up 100% of Medicaid payments in this category for Vista in 2024.
Additionally, a small subset of billing codes captured most Medicaid payments within this category.
In Vista, year-over-year Medicaid payments for the National Codes Established for State Medicaid Agencies category climbed 10% from 2023 to 2024, outpacing the 5% increase observed across all Medicaid claim categories in the city over the same interval.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures reached approximately $871.7 billion for fiscal year 2023. That figure represented around 18% of total national health care expenditures, up from $613.5 billion recorded in 2019 before the COVID-19 pandemic.
This growth equates to an increase of roughly 40% over several years, driven in large part by increased enrollment and greater utilization during and after the COVID-19 pandemic.
Recent federal budget policy adopted during the Trump administration included initiatives to decrease federal Medicaid dollars and alter the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is forecasted to reduce federal Medicaid funding by more than $1 trillion over ten years and adds work requirements and higher cost-sharing, potentially cutting coverage and access for some beneficiaries. The result is likely to increase costs for states and put limits on federal growth, even as Medicaid continues to cover tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $15,370,024 | 4.1% |
| 2021 | $17,494,565 | 13.8% |
| 2022 | $14,150,647 | -19.1% |
| 2023 | $17,090,338 | 20.8% |
| 2024 | $18,802,251 | 10% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $18,802,251 | 58.1% |
| 2 | Medicine Services and Procedures | $2,955,853 | 9.1% |
| 3 | Temporary National Codes (Non-Medicare) | $2,404,096 | 7.4% |
| 4 | Procedures / Professional Services | $1,550,036 | 4.8% |
| 5 | Evaluation and Management | $1,345,469 | 4.2% |
| 6 | Anesthesia | $1,282,650 | 4% |
| 7 | Alcohol and Drug Abuse Treatment | $1,225,210 | 3.8% |
| 8 | Dental Services | $1,110,939 | 3.4% |
| 9 | Medical And Surgical Supplies | $703,425 | 2.2% |
| 10 | Pathology and Laboratory Procedures | $409,998 | 1.3% |
| 11 | Ambulance and Other Transport Services and Supplies | $300,632 | 0.9% |
| 12 | Drugs Administered Other than Oral Method | $88,179 | 0.3% |
| 13 | Vision Services | $84,613 | 0.3% |
| 14 | Surgery | $69,123 | 0.2% |
| 15 | Durable Medical Equipment | $6,106 | <0.1% |
| 16 | Orthotic Procedures and services | $615 | <0.1% |
| 17 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 17 | Radiology Procedures | $0 | <0.1% |
| 17 | Screening Procedures | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| T1015 | Clinic service | $17,768,309 | 692 |
| T2031 | Assist living waiver/diem | $923,278 | 11 |
| T1001 | Nursing assessment/evaluatn | $53,683 | 8 |
| T4541 | Large disposable underpad | $21,078 | 20 |
| T4534 | Youth size pull-on | $16,532 | 7 |
| T1017 | Targeted case management | $8,040 | 3 |
| T4530 | Ped size brief/diaper lg | $4,417 | 3 |
| T4523 | Adult size brief/diaper lg | $4,342 | 5 |
| T4535 | Disposable liner/shield/pad | $2,478 | 4 |
| T4524 | Adult size brief/diaper xl | $90 | 1 |
| T1019 | Personal care ser per 15 min | $0 | 1 |
| T2007 | Non-emer transport wait time | $0 | 5 |
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.
