San Antonio sees 42.2% surge in Medicaid payments for ambulance and transport services in 2024

Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows that Medicaid providers in San Antonio billed $24,644,452 for Ambulance and Other Transport Services and Supplies in 2024. That total represents a 42.2% increase over 2023, when area providers claimed $17,326,266 for this service group.

Medicaid, a public health insurance program administered by the states and jointly financed by federal and state governments, offers coverage to low-income adults, seniors, children, and individuals with disabilities. It is among the largest components of the nation’s health care system.

Since Medicaid payments are funded by public dollars, shifts in local billing provide insight into how health care resources are apportioned within communities.

The Ambulance and Other Transport Services and Supplies category consists of Medicaid-billed services grouped according to the nature of care rendered, classified through standardized HCPCS and CPT code sets. In compiling this analysis, each billing code was allocated to a single category based on specific code prefixes and numerical ranges, ensuring related services could be tracked collectively while avoiding duplicate tallying and maintaining accurate historical rankings.

Ambulance and Other Transport Services and Supplies ranked sixth in overall Medicaid payouts among San Antonio service categories for 2024, amid increases in several other categories.

Across Texas, this same category placed eighth by total Medicaid payments in 2024.

From 2019 to 2024, Medicaid payments in San Antonio for the Ambulance and Other Transport Services and Supplies category grew by $21,225,384, or 620.8%. Strongest gains were recorded year over year in 2021 and 2020, reflecting periods of accelerated growth.

Although payments spanned San Antonio, most Medicaid reimbursement for this category was concentrated within a few ZIP codes. In 2024, ZIP codes 78238, 78257 and 78216 had the highest Medicaid payments, totaling $9,679,140, $6,218,528 and $2,850,338, respectively. Combined, these 3 ZIP codes comprised 76.1% of all area Medicaid payments tied to the category that year.

Only a small subset of billing codes made up the majority of category spending within Ambulance and Other Transport Services and Supplies.

For context, while Medicaid payments in San Antonio tied to the Ambulance and Other Transport Services and Supplies category increased 42.2% between 2024 and 2023, the citywide average for all categories rose 8.5% during the same period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures totaled about $871.7 billion in fiscal year 2023, representing roughly 18% of all national health expenses. This rose sharply from approximately $613.5 billion in 2019, ahead of the COVID-19 pandemic.

This reflects a nearly 40% rise over several years, attributed largely to expanded coverage and increased usage during and after the pandemic.

Recent Trump administration budget actions have featured measures designed to reduce federal Medicaid spending and overhaul the program. The “One Big Beautiful Bill Act,” enacted in 2025, is estimated to cut more than $1 trillion from federal Medicaid funding over ten years and adds provisions for work requirements and higher cost-sharing. These changes are expected to decrease some beneficiary coverage and funding, increase responsibilities for states, and place constraints on federal Medicaid growth even as the program maintains services for millions 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.