In 2024, Medicaid providers in Fairfield invoiced $2,152,105 for services within the Procedures / Professional Services category, the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represented a 10.4% increase over the $1,949,489 reported for the category in 2023.
Medicaid, administered by individual states with joint federal and state funding, insures low-income people, families, the elderly, children and those with disabilities, comprising a significant portion of the U.S. health care network.
Since Medicaid outlays are derived from public funds, shifts in local claims patterns highlight how health care resources are used in communities.
The “Procedures / Professional Services” grouping includes a set of Medicaid services categorized by care type using standardized HCPCS and CPT codes. During this analysis, each billing code was assigned solely to one service group, consistently using code prefixes and numeric ranges, which facilitated tracking of similar service types and accurate comparison over the years.
Despite overall spending rising for various service categories, Procedures / Professional Services placed seventh among Fairfield’s Medicaid payment categories in 2024.
The Procedures / Professional Services category was ranked sixth by total Medicaid payments in 2024 at the state level in California.
From 2019 through 2024, Medicaid expenditures for Procedures / Professional Services in Fairfield grew by $1,737,577, or 419.2%. Notably, the fastest increases happened in several individual years, including both 2023 and 2022.
Although utilization within the Procedures / Professional Services group extended citywide, payments in 2024 were primarily concentrated in a small number of ZIP codes. ZIP code 94533 saw $1,996,743, while 94534 accounted for $155,360. Together, these 2 ZIP codes represented 100% of Fairfield Medicaid spending in this category for the year.
Most Medicaid allocations inside the Procedures / Professional Services segment went to a select collection of billing codes.
For perspective, the 10.4% increase in Medicaid payments for Procedures / Professional Services in Fairfield from 2023 to 2024 was slightly higher than the overall 10.1% increase across all Medicaid claim categories citywide in the same period.
Centers for Medicare & Medicaid Services data show that overall federal and state Medicaid spending hit about $871.7 billion in fiscal 2023, representing approximately 18% of total U.S. health expenditures, up from $613.5 billion in 2019 before the pandemic.
This jump reflects some 40% growth in a few years, largely caused by higher program enrollment and more use of services during and after COVID-19.
Recent national budget measures under the Trump administration have proposed major reductions in federal Medicaid support and program restructuring. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years, introducing work requirements and more cost-sharing. These changes are projected to lower federal support, increase state responsibilities and limit coverage expansion, even as tens of millions continue to depend on Medicaid.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $414,528 | -16.1% |
| 2021 | $324,647 | -21.7% |
| 2022 | $647,844 | 99.6% |
| 2023 | $1,949,489 | 200.9% |
| 2024 | $2,152,104 | 10.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $18,437,785 | 25.4% |
| 2 | Alcohol and Drug Abuse Treatment | $14,532,059 | 2<0.1% |
| 3 | National Codes Established for State Medicaid Agencies | $12,825,725 | 17.7% |
| 4 | Medicine Services and Procedures | $12,580,040 | 17.3% |
| 5 | Radiology Procedures | $2,615,359 | 3.6% |
| 6 | Ambulance and Other Transport Services and Supplies | $2,606,489 | 3.6% |
| 7 | Procedures / Professional Services | $2,152,104 | 3% |
| 8 | Pathology and Laboratory Procedures | $1,540,822 | 2.1% |
| 9 | Temporary National Codes (Non-Medicare) | $1,463,678 | 2% |
| 10 | Anesthesia | $1,457,848 | 2% |
| 11 | Surgery | $600,762 | 0.8% |
| 12 | Drugs Administered Other than Oral Method | $563,536 | 0.8% |
| 13 | Dental Services | $514,194 | 0.7% |
| 14 | Hearing Services | $228,693 | 0.3% |
| 15 | Durable Medical Equipment | $224,672 | 0.3% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $93,132 | 0.1% |
| 17 | Medical And Surgical Supplies | $31,703 | <0.1% |
| 18 | Temporary Codes | $30,630 | <0.1% |
| 19 | Vision Services | $5,319 | <0.1% |
| 20 | Enteral and Parenteral Therapy | $2,037 | <0.1% |
| 21 | Outpatient PPS | $1,503 | <0.1% |
| 22 | Administrative, Miscellaneous and Investigational | $62 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| G2212 | Prolong outpt/office vis | $1,851,504 | 56 |
| G9012 | Other specified case mgmt | $183,800 | 20 |
| G0480 | Drug test def 1-7 classes | $89,743 | 11 |
| G0500 | Mod sedat endo service >5yrs | $21,676 | 14 |
| G0279 | Tomosynthesis, mammo | $4,300 | 9 |
| G0467 | Fqhc visit, estab pt | $672 | 28 |
| G9920 | Scrning perf and negative | $406 | 1 |
| G0008 | Admin influenza virus vac | $0 | 1 |
| G0439 | Ppps, subseq visit | $0 | 6 |
| G2025 | Dis site tele svcs rhc/fqhc | $0 | 16 |
| G2078 | Take-home meth | $0 | 1 |
| G2211 | Complex e/m visit add on | $0 | 2 |
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.
