Walnut Creek Medicaid providers reported $22,511,086 in billings for Medicine Services and Procedures in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 51.3% increase over 2023, when providers billed $14,883,208 for the same services.
Medicaid is a state-administered public health insurance program funded through federal and state government contributions. It provides coverage to low-income individuals and families, seniors, children, and those with disabilities, making up a significant portion of the U.S. health care landscape.
Because taxpayer dollars finance Medicaid, fluctuations in local billing levels indicate how public health care resources are distributed in a particular community.
The “Medicine Services and Procedures” classification comprises services billed to Medicaid and grouped by care type, based on shared HCPCS and CPT code definitions. For this report, specific billing codes were allocated to a single service category using consistent code prefixes and numerical ranges, allowing for accurate grouping and analysis while preventing duplicate counts and maintaining valid rankings across years.
Medicine Services and Procedures was the second-highest Medicaid payment category in Walnut Creek in 2024, with spending rising across several other service categories as well.
Across California, Medicine Services and Procedures was the third-largest Medicaid payment category statewide in 2024.
Over the five-year period ending in 2024, Medicaid payments for Medicine Services and Procedures in Walnut Creek grew by $14,890,976, or 195.4%. The rise in spending was particularly pronounced in some years, with substantial annual increases reported in 2020 and 2021.
Although spending for Medicine Services and Procedures was spread across the city, payments were concentrated in a small number of ZIP codes. In 2024, the highest Medicaid payments for these services were in ZIP code 94598, totaling $20,975,460, followed by 94597 at $879,549, and 94596 with $656,075. Together, these 3 ZIP codes represented 100% of Medicaid payments for Medicine Services and Procedures in Walnut Creek for the year.
Medicaid payments for Medicine Services and Procedures were also focused among a select group of billing codes within the category.
Compared to the 51.3% year-over-year increase for Medicine Services and Procedures in Walnut Creek from 2023 to 2024, all Medicaid claim categories in the city saw a combined increase of 62.6% over the same period.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023, which made up around 18% of all U.S. health expenditures, climbing from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.
This growth equates to an approximately 40% rise over a few years, largely attributed to increased program enrollment and greater usage during and after the pandemic.
Recent federal budget actions initiated by the Trump administration have included substantial proposals to reduce federal Medicaid outlays and alter the program’s structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to decrease federal Medicaid spending by more than $1 trillion over a decade, introducing initiatives such as work requirements and higher cost-sharing that may reduce access and funding for certain recipients. As a result, more financial responsibility is expected to shift to the states, potentially restraining the pace of federal Medicaid growth, even as the program continues to support millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $7,620,110 | 29.7% |
| 2021 | $9,724,721 | 27.6% |
| 2022 | $12,142,202 | 24.9% |
| 2023 | $14,883,207 | 22.6% |
| 2024 | $22,511,085 | 51.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $109,539,450 | 64% |
| 2 | Medicine Services and Procedures | $22,511,085 | 13.2% |
| 3 | Evaluation and Management | $15,921,216 | 9.3% |
| 4 | Drugs Administered Other than Oral Method | $8,557,622 | 5% |
| 5 | Radiology Procedures | $3,441,841 | 2% |
| 6 | Surgery | $2,916,332 | 1.7% |
| 7 | Anesthesia | $1,909,611 | 1.1% |
| 8 | Administrative, Miscellaneous and Investigational | $1,740,646 | 1% |
| 9 | National Codes Established for State Medicaid Agencies | $1,294,463 | 0.8% |
| 10 | Pathology and Laboratory Procedures | $1,177,053 | 0.7% |
| 11 | Temporary National Codes (Non-Medicare) | $604,053 | 0.4% |
| 12 | Procedures / Professional Services | $533,440 | 0.3% |
| 13 | Orthotic Procedures and services | $431,693 | 0.3% |
| 14 | Temporary Codes | $126,046 | 0.1% |
| 15 | Outpatient PPS | $81,048 | <0.1% |
| 16 | Prosthetic Procedures | $77,057 | <0.1% |
| 17 | Chemotherapy Drugs | $76,610 | <0.1% |
| 18 | Dental Services | $71,641 | <0.1% |
| 19 | Ambulance and Other Transport Services and Supplies | $38,164 | <0.1% |
| 20 | Vision Services | $16,866 | <0.1% |
| 21 | Durable Medical Equipment | $15,245 | <0.1% |
| 22 | Medical And Surgical Supplies | $1,844 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90885 | Psy evaluation of records | $13,728,603 | 12 |
| 96116 | Nubhvl xm phys/qhp 1st hr | $2,501,253 | 22 |
| 90999 | Unlisted dialysis procedure | $923,507 | 20 |
| 97530 | Therapeutic activities | $599,343 | 135 |
| 90837 | Psytx w pt 60 minutes | $478,768 | 13 |
| 93306 | Tte w/doppler complete | $382,896 | 160 |
| 95144 | Antigen therapy services | $348,093 | 64 |
| 92507 | Tx sp lang voice comm indiv | $314,139 | 11 |
| 96121 | Nubhvl xm phy/qhp ea addl hr | $275,123 | 11 |
| 93010 | Electrocardiogram report | $247,361 | 163 |
| 97110 | Therapeutic exercises | $222,317 | 130 |
| 92134 | Cptrz oph dx img pst sgm rta | $152,507 | 100 |
| 92250 | Fundus photography w/i&r | $140,552 | 95 |
| 90791 | Psych diagnostic evaluation | $121,956 | 13 |
| 96374 | Ther/proph/diag inj iv push | $112,223 | 24 |
| 92014 | Compre oph exam est pt 1/> | $104,686 | 111 |
| 97112 | Neuromuscular reeducation | $103,392 | 44 |
| 92004 | Compre oph exam new pt 1/> | $100,800 | 77 |
| 93970 | Extremity study | $92,901 | 59 |
| 97140 | Manual therapy 1/> regions | $82,216 | 46 |
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.
