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Per-Enrollee Spending

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Medicaid July 2026

New York pays providers more than double per enrollee what California does

Dividing each state's Medicaid provider payments by its enrollment puts the three states on one scale. New York reached $7,379 per enrollee in 2024. The gap is partly real generosity, especially home care, and partly differences in what each state reports to the federal claims system.

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New York's provider payments per enrollee run more than double California's
Medicaid paid amounts on HCPCS-coded claim lines per enrollee per year, 2018 to 2024. Dollars are payments to in-state providers divided by average monthly Medicaid and CHIP enrollment.
Created by Tal Roded · NYCuriosity · Sources: HHS Open Data, CMS enrollment data

New York spent $7,379 per enrollee on these claims in 2024, against $3,239 in California and $5,464 in Texas. Some of the gap is real program generosity: New York's Medicaid covers more home care and personal assistance services than almost any state, and those services bill through exactly the codes this dataset captures.

Read the Texas line carefully. Its jump from $1,607 in 2020 to $4,382 in 2021 is too fast to be a real spending change. States improved their T-MSIS managed care encounter reporting over this window, so part of every state's growth, and most of that Texas jump, is more complete data rather than more spending.

What this measures: Medicaid and CHIP paid amounts on outpatient and professional claim lines carrying a HCPCS procedure code, attributed to states by the billing provider's practice location in the NPPES registry. It excludes institutional per-diem claims, most pharmacy billing, and payments that could not be tied to a valid billing NPI, so it is a large subset of Medicaid spending rather than the whole program.

Denominator: average monthly Total Medicaid and CHIP Enrollment for each state and year from the CMS Performance Indicator dataset.

2024 figures are preliminary and will change as states finalize T-MSIS submissions.

Sources: HHS Open Data, Medicaid Provider Spending by HCPCS; CMS NPPES; CMS State Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Data. Author's analysis; replication steps in the methodology.