Los Gatos Medicaid providers billed $559,400 in 2024 for services listed under the Alcohol and Drug Abuse Treatment category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 14.1% rise from 2023, when claims for the same services totaled $490,473.
Medicaid, a joint federal-state health program, provides coverage for low-income people and families, seniors, children, and individuals with disabilities. It is among the largest segments of the U.S. health care system, with funding from both federal and state governments; more details can be found at this explainer.
Since Medicaid funds originate from taxpayers, shifts in local billing reflect the allocation of public health funds throughout each community.
The Alcohol and Drug Abuse Treatment category comprises a selection of Medicaid service billings classified by care type, set apart by standardized HCPCS and CPT codes. For analytical accuracy, each code was placed into one care group using consistent prefixed groupings—minimizing double counting while supporting ranking comparisons over time.
Spending in the Alcohol and Drug Abuse Treatment category topped Medicaid payments in Los Gatos across all service categories in 2024, even as growth was seen in several other areas.
Statewide, the Alcohol and Drug Abuse Treatment category ranked fourth in overall Medicaid payment volume in California for 2024.
From 2019 through 2024, payments for services in this category grew in Los Gatos by $573—or about 0.1%. Larger year-over-year gains were noted especially in 2021 and 2023, indicative of periods where spending growth accelerated.
Medicaid claims for Alcohol and Drug Abuse Treatment were distributed throughout Los Gatos but centered heavily in select ZIP codes. In particular, ZIP code 95030 saw $559,400 in related payments in 2024, making up 100% of Medicaid dollars for this category within the city during that timeframe.
Within the overall category, a small selection of billing codes accounted for the majority of Medicaid payments.
To compare, Los Gatos Medicaid spending in this service category increased 14.1% from 2023 to 2024, exceeding the 4.8% change seen across all Medicaid claim types locally that same period.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures totaled approximately $871.7 billion in fiscal year 2023, about 18% of all U.S. health spending. This total rose dramatically from around $613.5 billion in 2019, before the pandemic.
This growth amounts to an increase of nearly 40% in just a few years, largely fueled by increases in enrollment and service use during and after the COVID-19 public emergency.
Congressional budget actions under the Trump administration have brought forward major proposals to shrink federal Medicaid appropriations and restructure elements of the program. The “One Big Beautiful Bill Act,” enacted in 2025, will reduce federal Medicaid outlays by more than $1 trillion over 10 years. These legislative changes, which include stricter work requirements and higher cost-sharing, are projected to decrease eligibility or funding for some users, shifting additional financial responsibilities to individual states while federal growth slows—even as millions still rely on Medicaid coverage.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $558,827 | 12.8% |
| 2021 | $631,726 | 13% |
| 2022 | $414,297 | -34.4% |
| 2023 | $490,472 | 18.4% |
| 2024 | $559,400 | 14.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Alcohol and Drug Abuse Treatment | $559,400 | 32.1% |
| 2 | Pathology and Laboratory Procedures | $362,231 | 20.8% |
| 3 | Medicine Services and Procedures | $319,133 | 18.3% |
| 4 | Evaluation and Management | $239,942 | 13.8% |
| 5 | Radiology Procedures | $98,881 | 5.7% |
| 6 | Anesthesia | $60,449 | 3.5% |
| 7 | Temporary National Codes (Non-Medicare) | $43,848 | 2.5% |
| 8 | Medical And Surgical Supplies | $23,433 | 1.3% |
| 9 | Drugs Administered Other than Oral Method | $16,090 | 0.9% |
| 10 | Surgery | $15,321 | 0.9% |
| 11 | Administrative, Miscellaneous and Investigational | $2,027 | 0.1% |
| 12 | Vision Services | $1,361 | 0.1% |
| 13 | Temporary Codes | $1,220 | 0.1% |
| 14 | Dental Services | $1,115 | 0.1% |
| 15 | Orthotic Procedures and services | $454 | <0.1% |
| 16 | Procedures / Professional Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| H2019 | Ther behav svc, per 15 min | $353,050 | 11 |
| H0032 | Mh svc plan dev by non-md | $179,982 | 11 |
| H0031 | Mh health assess by non-md | $26,368 | 8 |
| H0004 | Alcohol and/or drug services | $0 | 11 |
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.
