Mission Viejo saw Medicaid payments total at least $92,229 in 2024 for COVID-19–specific services billed using targeted HCPCS codes, based on information from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This marked a 13.5% rise over 2023, when claims for the same set of codes reached $81,237.
Medicaid, operated by the states and funded through both federal and state sources, provides coverage for low-income residents, children, seniors and those with disabilities. It is considered one of the largest segments of the nation’s health care system.
Because taxpayer funds support Medicaid, shifts in local billing patterns highlight how public health resources are distributed within a community.
This analysis identified COVID-19–related services using HCPCS codes classified or described as “COVID-19” or “coronavirus” in claims data or supporting references. As a result, these amounts reflect only those services specifically labeled as COVID-related, and do not factor in broader pandemic care that might be billed under more general codes.
For additional context, in 2024 San Jose reported the highest Medicaid claims for COVID-19 services in California, totaling $5,601,479.
In Mission Viejo, three providers billed Medicaid for COVID-19–related care in 2024. The most commonly billed code, COVID Specific, generated $91,872 in charges.
The average billed amount per provider for such services in Mission Viejo was $30,743, below California’s average of $52,976 per provider.
During the pandemic, COVID-19–specific billing accounted for a substantial portion of Medicaid spending increases for Mission Viejo.
Total Medicaid payments for other categories rose by $12,793,494 from 2020 to 2024, a 176.3% jump.
In the two years before the pandemic, annual Medicaid payments in Mission Viejo averaged $5,640,003.
Data from the Centers for Medicare & Medicaid Services shows federal and state Medicaid spending together reached approximately $871.7 billion for fiscal year 2023, representing around 18% of national health costs. This was a significant increase from about $613.5 billion in 2019 before COVID-19.
This change reflects roughly 40% growth in recent years, largely fueled by rising enrollment and increased usage during and after the pandemic period.
Recent federal budgets during the Trump administration have included proposals to reduce federal Medicaid funds and revise the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to reduce federal Medicaid funding by more than $1 trillion over 10 years. It also introduces changes such as work requirements and greater cost-sharing, which could lower coverage and resources for some enrollees. These adjustments are anticipated to increase financial responsibility for states and place new limits on federal support for Medicaid, while the program continues to cover tens of millions of people.
| Year | COVID-19–Related Payments | COVID-19 Payments % Change (YoY) | Total Medicaid Payments |
|---|---|---|---|
| 2024 | $92,229 | 13.5% | $20,141,753 |
| 2023 | $81,237 | -64.8% | $18,890,540 |
| 2022 | $230,630 | 2.6% | $8,613,457 |
| 2021 | $224,805 | 643.8% | $7,850,644 |
| 2020 | $30,225 | N/A | $7,286,255 |
| 2019 | $0 | N/A | $7,326,169 |
| 2018 | $0 | N/A | $3,953,838 |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 87635 | COVID Specific | $91,872 | 2,109 |
| 87811 | Immunoassay | $356 | 25 |
Note: Includes HCPCS codes explicitly labeled for COVID-19 services; totals do not represent all pandemic-related health care spending.
Information for this report comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data is available here.
