Sausalito Medicaid payments connected to national Medicaid code group rose 8.8% in 2024

In 2024, Sausalito Medicaid providers billed $2,714,298 for services categorized under the National Codes Established for State Medicaid Agencies, U.S. Department of Health and Human Services Medicaid Provider Spending data shows. This represents an 8.8% rise from 2023, when providers filed $2,494,120 in claims for these services.

Medicaid, a state-run public health insurance initiative funded jointly at the federal and state levels, provides coverage to low-income residents, families, seniors, children, and people with disabilities, making it one of the core components of U.S. health care.

As Medicaid is financed by taxpayers, shifts in area billing amounts indicate how public health funds are utilized locally.

The “National Codes Established for State Medicaid Agencies” classification groups Medicaid-billed services by care type, relying on standardized HCPCS and CPT code designations. For this assessment, each billing code is placed into one service group according to code prefixes and number sequences, enabling consistent analysis of related services, avoiding duplicate counts, and ensuring reliable rankings over time.

Although broader Medicaid spending rose across service groups, National Codes Established for State Medicaid Agencies held the leading spot in Sausalito by total Medicaid payments in 2024.

Statewide in California, the National Codes Established for State Medicaid Agencies group also held the top ranking for total payments in 2024.

Between 2019 and 2024, Sausalito’s Medicaid payments tied to the National Codes Established for State Medicaid Agencies category grew by $996,867, or 58%. Growth in expenditure picked up during select years, particularly 2020 and 2023, with notable increases over the previous periods.

Medicaid spending within the National Codes Established for State Medicaid Agencies category spanned the city, but most payments were concentrated within a few ZIP codes. In 2024, ZIP code 94965 saw Medicaid payments totaling $2,714,298. The top ZIP code represented 100% of city Medicaid payments in this category for the year.

Payments for services in this category were primarily attributed to a few billing codes.

In Sausalito, Medicaid payments tied to these service codes rose 8.8% between 2023 and 2024. By comparison, overall city Medicaid claims grew by 8.6% in the same timeframe.

Centers for Medicare & Medicaid Services reports joint federal and state Medicaid spending reached about $871.7 billion in fiscal 2023, making up an estimated 18% of national health expenditures—a sharp rise from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.

This increase is roughly a 40% rise over a few years, mainly attributed to higher enrollment and increased use of services during and following the pandemic period.

Recent legislation at the federal level during the Trump administration has included significant proposals to trim federal Medicaid funding and restructure the program. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years. It will also implement work requirements and higher cost-sharing measures, potentially reducing access and funding for some Medicaid recipients. These policy shifts are poised to transfer additional costs to states and may curb the increase of federal Medicaid support levels as Medicaid continues to serve millions of Americans.

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.