Evaluation and Management spending by Medicaid in Clinton totals $26,860 for 2024

Clinton’s Medicaid providers billed $26,860 for Evaluation and Management services in 2024, as reported in data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects an increase of 15.8% compared to 2023, when providers filed $23,196 in claims under the same service type.

Medicaid operates as a public health insurance program administered by states and funded through federal and state contributions. It offers coverage for low-income individuals and families, seniors, children and people with disabilities, making the program one of the largest in the U.S. health system.

Because taxpayers fund Medicaid payments, shifts in local billing amounts highlight how communities distribute public health care resources.

The Evaluation and Management category represents Medicaid-billed care grouped by service type, organized using HCPCS and CPT code prefixes and numeric ranges. This method groups similar services for comparison, prevents duplicating claims, and ensures rankings remain accurate through the years.

Evaluation and Management placed as the second-largest Medicaid spending category in Clinton during 2024, part of a wider trend of increased category spending.

Statewide across Washington, Evaluation and Management also ranked second in total Medicaid outlays for the year.

From 2019 through 2024, Medicaid spending on Evaluation and Management in Clinton jumped by $25,319, or 1643.6%. The growth rate was particularly strong at designated times, including 2021 and 2022.

While payments for Evaluation and Management were seen throughout the city, most funds were concentrated in just a few ZIP codes. In 2024, ZIP code 98236 received $26,859 for these services, with the top-ranking ZIP code accounting for 100% of all local Medicaid Evaluation and Management spending that year.

A select number of individual billing codes accounted for most of the Medicaid payments within the broader Evaluation and Management category.

To compare, Clinton saw a 15.8% uptick in Evaluation and Management Medicaid payments from 2023 to 2024, closely paralleling the 15.8% overall rise across all Medicaid claim types in the area for the same time period.

The Centers for Medicare & Medicaid Services notes that federal and state Medicaid expenditures amounted to about $871.7 billion in fiscal 2023, accounting for approximately 18% of all national health outlays. This is a significant increase from around $613.5 billion in 2019, before the COVID-19 pandemic.

This marks around 40% growth over several years, with much of the increase underway due to broader enrollment and more service use during and after the pandemic era.

More recently, federal budget measures during the Trump administration featured potential Medicaid reductions, including changes set out by the “One Big Beautiful Bill Act,” signed into law in 2025. The law intends to cut federal Medicaid spending by over $1 trillion during the next decade and incorporates policy alterations like mandatory work provisions and raised cost-sharing, which may reduce benefits and funding for specific groups. As these proposals take effect, states are set to acquire a greater share of Medicaid’s costs, limiting federal outlays, even as the program continues serving tens of millions of people 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.