Fresno Medicaid billing for procedures and professional services reaches $37.8 million in 2024

Fresno Medicaid providers recorded $37,846,111 in claims for Procedures / Professional Services in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 13.3% increase from 2023, when claims for this category totaled $33,410,147.

Medicaid is a state-run, federally and state-funded public health insurance program serving low-income individuals and families, children, seniors, and people with disabilities. The program is among the largest in the U.S. health care system.

Because Medicaid is funded by taxpayers, shifts in local billing illustrate how public health care funds are used within communities.

The “Procedures / Professional Services” category encompasses services billed to Medicaid based on standardized HCPCS and CPT code groupings. In this analysis, each billing code fits one service group, sorted by consistent code prefixes and numeric intervals, allowing for accurate year-to-year comparisons and ranking without double counting services.

Medicaid expenditures increased across numerous categories, but for 2024, Procedures / Professional Services ranked fourth in Fresno for total Medicaid payments.

Statewide in California, Procedures / Professional Services ranked sixth in 2024 by total Medicaid payments.

Between 2019 and 2024, payments associated with Procedures / Professional Services in Fresno rose by $34,037,807, an 893.8% gain. The data shows periods of surging growth, notably strong increases in 2022 and 2023.

Payments were widely distributed throughout Fresno, but concentrated within a small group of ZIP codes. In 2024, ZIP code 93710 accounted for $25,770,299, 93726 registered $5,101,719, and 93711 tallied $2,957,546. These three ZIP codes comprised 89.4% of all Procedures / Professional Services Medicaid payments in Fresno in 2024.

Within the category, payments were also focused among relatively few billing codes.

For perspective, Medicaid payments for Procedures / Professional Services in Fresno climbed 13.3% from 2023 to 2024, compared to a 13.6% increase seen across all Medicaid categories in the city within that period.

The Centers for Medicare & Medicaid Services reports that combined federal and state Medicaid spending reached approximately $871.7 billion during fiscal 2023, making up around 18% of overall national health expenditures. This figure was up from nearly $613.5 billion in 2019, prior to the COVID-19 pandemic.

This increase amounts to about 40% growth in a few years, largely attributable to higher enrollment and greater usage during and following the pandemic.

Major federal budget bills from the Trump administration have introduced significant federal Medicaid funding reductions and changes to how the program is structured. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid spending by over $1 trillion through the next decade. The law also brings in work requirements and greater cost-sharing, potentially limiting coverage and support for some groups. These measures are likely to shift more financial responsibility to states and place limits on federal Medicaid growth, though the program continues to cover millions nationwide.

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.