In 2024, Douglas Medicaid providers submitted $394,136 in claims for Evaluation and Management services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 20.5% increase from 2023, when claims for this category totaled $327,154.
Medicaid, a public health insurance program overseen by states and financed jointly by federal and state funds, supports low-income individuals and families, seniors, children, and those with disabilities, and is a major segment of U.S. health care.
Because taxpayer dollars fund Medicaid payments, shifts in local billing are an indicator of how public health care resources are distributed in a specific community.
The “Evaluation and Management” label covers a set of Medicaid services defined by the type of care rendered, grouped using standard HCPCS and CPT codes. This analysis consistently assigned each billing code to one service category using code prefixes and ranges, enabling clear comparisons while preventing duplicate counting and supporting accurate rankings through time.
Multiple Medicaid service areas posted increases in spending, but Evaluation and Management stood as the third-largest category by total Medicaid payments in Douglas for 2024.
Statewide in Arizona, Evaluation and Management ranked third among all Medicaid payment categories for 2024.
In the five years leading up to 2024, Douglas saw Medicaid payments in the Evaluation and Management group rise by $1,632,958, or 80.6%. This growth included multiple periods of accelerated year-over-year increases, notably in 2023 and 2022.
Though spending on Evaluation and Management covered providers throughout Douglas, payments were concentrated in only a few ZIP codes. For 2024, ZIP code 85607 accounted for all $394,136 in Medicaid payments for this category, making up 100% of such spending citywide during the year.
Within Evaluation and Management, Medicaid disbursements were further concentrated among select individual billing codes.
To compare, Douglas Medicaid payments in this category rose 20.5% between 2024 and 2023, compared with a citywide increase of 4.8% for all Medicaid claim categories over the same time period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending totaled roughly $871.7 billion for fiscal year 2023, making up about 18% of all national health care expenses—up significantly from $613.5 billion in 2019, prior to the COVID-19 pandemic.
The difference marks an increase near 40% in only a few years, a result of heightened enrollment and greater utilization during and after the pandemic.
Recent federal budgets signed under the Trump administration introduced major proposals to cut federal Medicaid funds and reshape the program. One measure, the “One Big Beautiful Bill Act,” enacted in 2025, is projected to trim more than $1 trillion from federal Medicaid spending over 10 years and brings new work requirements and higher cost-sharing that could limit coverage and financial support for certain enrollees. These changes are likely to shift added funding responsibilities to states and restrict the rate of federal program expansion, while the system continues to serve millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $2,027,094 | -27.5% |
| 2021 | $1,777,864 | -12.3% |
| 2022 | $419,990 | -76.4% |
| 2023 | $327,154 | -22.1% |
| 2024 | $394,136 | 20.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $10,075,482 | 87.2% |
| 2 | Ambulance and Other Transport Services and Supplies | $476,593 | 4.1% |
| 3 | Evaluation and Management | $394,136 | 3.4% |
| 4 | Alcohol and Drug Abuse Treatment | $238,124 | 2.1% |
| 5 | Medicine Services and Procedures | $165,693 | 1.4% |
| 6 | Temporary National Codes (Non-Medicare) | $141,066 | 1.2% |
| 7 | Surgery | $22,557 | 0.2% |
| 8 | Vision Services | $20,350 | 0.2% |
| 9 | Dental Services | $20,283 | 0.2% |
| 10 | Procedures / Professional Services | $177 | <0.1% |
| 11 | Pathology and Laboratory Procedures | $50 | <0.1% |
| 12 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| 12 | Medical And Surgical Supplies | $0 | <0.1% |
| 12 | Radiology Procedures | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99284 | Emergency dept visit mod mdm | $210,852 | 73 |
| 99214 | Office o/p est mod 30 min | $84,803 | 93 |
| 99283 | Emergency dept visit low mdm | $77,051 | 51 |
| 99215 | Office o/p est hi 40 min | $19,748 | 9 |
| 99285 | Emergency dept visit hi mdm | $1,616 | 1 |
| 99213 | Office o/p est low 20 min | $62 | 66 |
| 99000 | Specimen handling office-lab | $0 | 39 |
| 99173 | Visual acuity screen | $0 | 32 |
| 99177 | Ocular instrumnt screen bil | $0 | 7 |
| 99202 | Office o/p new sf 15 min | $0 | 1 |
| 99203 | Office o/p new low 30 min | $0 | 13 |
| 99204 | Office o/p new mod 45 min | $0 | 18 |
| 99212 | Office o/p est sf 10 min | $0 | 12 |
| 99381 | Init pm e/m new pat infant | $0 | 5 |
| 99391 | Per pm reeval est pat infant | $0 | 18 |
| 99392 | Prev visit est age 1-4 | $0 | 18 |
| 99393 | Prev visit est age 5-11 | $0 | 17 |
| 99394 | Prev visit est age 12-17 | $0 | 14 |
| 99395 | Prev visit est age 18-39 | $0 | 14 |
| 99396 | Prev visit est age 40-64 | $0 | 10 |
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.
