Dana Point Medicaid spending reaches $1.3 million for state agency code services in 2024

In 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows that Medicaid providers in Dana Point billed $1,265,410 for services under the National Codes Established for State Medicaid Agencies category. This total reflects a 142.1% rise from 2023, when providers submitted $522,757 in claims for this service group.

Medicaid, a joint federal and state program, offers public health insurance coverage for low-income families and individuals, seniors, children, and people with disabilities. As one of the nation’s largest health care programs, it is funded by both federal and state governments.

Changes in Medicaid billing by local providers illustrate how taxpayer-funded health care resources are distributed in a given community.

The “National Codes Established for State Medicaid Agencies” category encompasses a set of Medicaid-billed services organized by the nature of care provided, relying on standardized HCPCS and CPT codes. For this analysis, each billing code was assigned exclusively to one service category, using agreed code prefixes and ranges to group similar services together while preventing double counting and ensuring consistent rankings over time.

National Codes Established for State Medicaid Agencies saw the highest Medicaid spending in Dana Point among all categories in 2024.

The category also ranked as the top recipient of Medicaid dollars statewide in California in 2024.

Looking at the five-year period leading up to 2024, Medicaid spending in Dana Point within the National Codes Established for State Medicaid Agencies rose by $1,265,410, or 0%. The rate of growth was especially rapid during certain years, including significant gains in both 2023 and 2022.

Although payments for these services occurred citywide, most Medicaid dollars were focused in a small number of ZIP codes. In 2024, the highest payment was recorded in ZIP code 92629, with $1,265,409 in claims. Collectively, the top ZIP code accounted for all Medicaid spending associated with the category that year in Dana Point.

A small subset of billing codes within the National Codes Established for State Medicaid Agencies category captured the majority of Medicaid payments.

For context, Dana Point’s Medicaid payments linked to this category rose 142.1% from 2023 to 2024, outpacing the 129.8% increase seen across all Medicaid claim types in the city during the same interval.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023, making up about 18% of national health care spending—an increase from roughly $613.5 billion in 2019 before the COVID-19 pandemic.

This represents a growth rate of nearly 40% over a few years, with the expansion attributed mainly to increased enrollment and service utilization during and following the pandemic.

Federal budget changes under the Trump administration have included major proposals to curb federal Medicaid funding and reshape the program. For instance, the “One Big Beautiful Bill Act” adopted in 2025 is anticipated to reduce federal Medicaid payments by more than $1 trillion over 10 years and implement new policies such as work requirements and higher cost-sharing, potentially reducing coverage and funding for particular enrollees. As a result, more costs are expected to shift onto states, potentially limiting future federal Medicaid support, even as the program continues to cover tens of millions across the country.

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.