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

Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database indicate that Medicaid providers in Gilroy submitted $442,113 in claims for the Procedures / Professional Services category in 2024. This figure represents a 133.4% increase from 2023, when claims stood at $189,437 for this service type.

Medicaid, one of the nation’s largest health programs, is administered by states and funded jointly by federal and state governments. It serves low-income populations, older adults, children, and people with disabilities.

Shifts in local Medicaid billing reveal how taxpayer-funded public health dollars are spent within specific areas.

The Procedures / Professional Services grouping covers a defined set of Medicaid-funded services identified by standardized HCPCS and CPT codes. The analysis utilized consistent code prefixes and ranges to assign each billing code to a single category, enabling a clearer view of trends while avoiding duplicate counts and maintaining accurate rankings.

While a number of Medicaid service categories noted higher spending, Procedures / Professional Services ranked fourth for total Medicaid payments in Gilroy during 2024.

Across California, Procedures / Professional Services was the sixth highest Medicaid payment category in 2024.

Examining the span from five years prior to 2024, Gilroy’s Medicaid payments for the Procedures / Professional Services category rose by $421,751, or 2071.3%. Certain years, like 2020 and 2022, saw considerable increases year over year.

Although spending on Procedures / Professional Services was citywide, it was concentrated in several ZIP codes. For 2024, ZIP code 95020 accounted for $442,113, making up 100% of Gilroy’s Medicaid payments in the Procedures / Professional Services category for the year.

Medicaid funding within this category was further focused among a small segment of billing codes.

To put it in context, Gilroy’s Medicaid payments for Procedures / Professional Services jumped by 133.4% between 2024 and 2023. During that time frame, all Medicaid claim categories in the city saw a 30.2% increase collectively.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid combined spending reached about $871.7 billion in fiscal 2023, nearly 18% of total U.S. health expenditures. This is up from approximately $613.5 billion in 2019, prior to the COVID-19 pandemic.

That change marks a roughly 40% rise over just several years, mainly due to increased enrollments and greater service use during and after the pandemic.

Recent federal budget policy under the Trump administration brought notable proposals for reducing federal Medicaid funding and modifying the program’s framework. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is forecast to trim more than $1 trillion from federal Medicaid spending over 10 years and establishes changes such as work requirements and expanded cost-sharing, potentially limiting both coverage and funding for some enrollees. These shifts are anticipated to increase state funding responsibilities and further slow the increase in federal support for Medicaid, even as the program remains essential to 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.