In 2024, Medicaid providers in Pomona submitted $731,494 in claims for services grouped under the Durable medical equipment (DME) Medicare administrative contractors (MACs) category, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 20.1% rise over 2023, when a total of $609,296 was billed for the same category of service.
Medicaid, administered by states with combined federal and state funding, covers low-income people, seniors, children, and those with disabilities, making it a major component of the U.S. health system.
Local trends in Medicaid billing help illustrate how public health funding is distributed at the community level, since Medicaid dollars are taxpayer-funded.
The “Durable medical equipment (DME) Medicare administrative contractors (MACs)” category includes Medicaid-billed services defined by the specific care provided, based on standardized HCPCS and CPT code groups. For the analysis, each billing code was assigned to a single service group using uniform code prefixes and ranges, allowing similar services to be assessed together, minimizing double counting, and maintaining accurate year-over-year rankings.
Despite increased Medicaid spending across multiple categories, Durable medical equipment (DME) Medicare administrative contractors (MACs) ranked 12th for total Medicaid payments in Pomona in 2024.
Statewide, the Durable medical equipment (DME) Medicare administrative contractors (MACs) category placed 23rd by total Medicaid payments in California in 2024.
From 2019 through 2024, Medicaid payments for Durable medical equipment (DME) Medicare administrative contractors (MACs) in Pomona grew by $560,235, or 327.1%. There were sizable year-to-year increases, particularly in 2022 and 2023.
Although Medicaid payments for this category were distributed across Pomona, most of the dollars were concentrated in a handful of ZIP codes. In 2024, ZIP code 91767 accounted for $731,493 in payments for the category, representing 100% of Medicaid spending for Durable medical equipment (DME) Medicare administrative contractors (MACs) services in the city.
Medicaid payments within the Durable medical equipment (DME) Medicare administrative contractors (MACs) category in Pomona were also focused on a small set of billing codes.
Looking at other categories, Medicaid spending tied to Durable medical equipment (DME) Medicare administrative contractors (MACs) in Pomona rose 20.1% from 2023 to 2024, compared to an 11.5% change across all Medicaid services in the city during the period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023. This accounted for about 18% of total U.S. health spending, a significant jump from $613.5 billion in 2019 before the COVID-19 pandemic.
This reflects nearly 40% growth over several years, largely attributable to expanded program enrollment and increased service use during and following the pandemic.
Recent federal budget measures enacted under the Trump administration have proposed reducing federal Medicaid funding and restructuring the program. For example, the “One Big Beautiful Bill Act,” signed in 2025, is set to decrease federal Medicaid funding by more than $1 trillion over the next decade and includes provisions like work requirements and elevated cost-sharing, potentially affecting coverage and spending for some enrollees. These changes could result in states absorbing a larger share of program costs and less federal funding growth, even as Medicaid continues to provide coverage to millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $171,259 | -62.9% |
| 2021 | $218,741 | 27.7% |
| 2022 | $413,994 | 89.3% |
| 2023 | $609,296 | 47.2% |
| 2024 | $731,493 | 20.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $12,460,577 | 18.7% |
| 2 | Pathology and Laboratory Procedures | $10,365,320 | 15.6% |
| 3 | Medicine Services and Procedures | $9,938,673 | 14.9% |
| 4 | Temporary National Codes (Non-Medicare) | $9,027,735 | 13.6% |
| 5 | National Codes Established for State Medicaid Agencies | $5,994,196 | 9% |
| 6 | Radiology Procedures | $4,608,552 | 6.9% |
| 7 | Procedures / Professional Services | $3,221,810 | 4.8% |
| 8 | Dental Services | $2,636,852 | 4% |
| 9 | Durable Medical Equipment | $2,431,692 | 3.6% |
| 10 | Anesthesia | $2,263,431 | 3.4% |
| 11 | Surgery | $1,710,933 | 2.6% |
| 12 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $731,493 | 1.1% |
| 13 | Drugs Administered Other than Oral Method | $421,348 | 0.6% |
| 14 | Chemotherapy Drugs | $408,643 | 0.6% |
| 15 | Vision Services | $87,535 | 0.1% |
| 16 | Temporary Codes | $80,725 | 0.1% |
| 17 | Alcohol and Drug Abuse Treatment | $53,984 | 0.1% |
| 18 | Diagnostic Radiology Services | $41,905 | 0.1% |
| 19 | Administrative, Miscellaneous and Investigational | $36,685 | 0.1% |
| 20 | Pathology and Laboratory Services | $35,334 | 0.1% |
| 21 | Hearing Services | $30,147 | <0.1% |
| 22 | Medical And Surgical Supplies | $18,679 | <0.1% |
| 23 | Coronavirus Diagnostic Panel | $16,123 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| K0004 | High strength ltwt whlchr | $601,099 | 11 |
| K0053 | Elevate footrest articulate | $69,649 | 11 |
| K0040 | Adjustable angle footplate | $60,744 | 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.
