Medicaid payments for Procedures / Professional Services reach $442,113 in Gilroy for 2024

In 2024, providers in Gilroy billed a total of $442,113 to Medicaid for services within the Procedures / Professional Services category, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 133.4% rise from the $189,437 billed in 2023 for the same group of services.

Medicaid is a publicly funded health program administered by individual states, with funding provided by both federal and state governments. The program serves low-income residents, older adults, children, and people with disabilities, and is a significant component of the nation’s health care system.

Since taxpayer resources finance Medicaid payments, shifts in local billing volumes provide insight into how public health care resources are distributed at the community level.

The Procedures / Professional Services category groups Medicaid-billed care determined by distinct service types, with assignments based on standardized HCPCS and CPT codes. For this report, every billing code was mapped to a single category using prefix and number ranges to collect related services, prevent multiple counts, and support analysis of category trends and rankings historically.

Procedures / Professional Services was the fourth-largest service group by Medicaid payments in Gilroy in 2024, even as total spending grew across numerous categories.

On the statewide level, Procedures / Professional Services ranked sixth among service categories by total Medicaid paid claims in California for 2024.

During the five years before 2024, Medicaid payments for Procedures / Professional Services increased by $421,751—a 2071.3% increase. Some years saw notable acceleration in spending, especially 2020 and 2022.

The distribution of payments for Procedures / Professional Services was widespread, but most spending was concentrated in a small number of ZIP codes. For 2024, ZIP code 95020 led with $442,113 in Medicaid payments for the category, representing the total sum dispersed within Gilroy during that time.

A narrow set of individual billing codes in the Procedures / Professional Services category were responsible for most Medicaid payments during the year.

To place this in context, Procedures / Professional Services Medicaid payments surged 133.4% in Gilroy from 2023 to 2024, whereas total Medicaid claims for all categories citywide changed 30.2% in the same period.

The Centers for Medicare & Medicaid Services reports combined state and federal spending for Medicaid totaled about $871.7 billion in fiscal 2023. That amounts to roughly 18% of the nation’s total health expenditures, up substantially from $613.5 billion in 2019 before the COVID-19 crisis.

This near 40% growth over several years is mainly attributed to both increased Medicaid enrollment and greater service utilization following the pandemic.

Trump-era federal budget laws have proposed substantial reductions to federal Medicaid funding and modifications to the program. For instance, the “One Big Beautiful Bill Act,” which became law in 2025, is expected to reduce federal Medicaid outlays by more than $1 trillion over 10 years, while imposing work requirements and higher cost-sharing for some enrollees. These adjustments could lead to lower coverage and federal support for affected groups, transfer additional fiscal responsibility to states, and are likely to slow expansion of federal Medicaid funding even as enrollment remains high 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.