Daly City Medicaid Evaluation and Management payments increase 42% in 2024

In 2024, Medicaid providers in Daly City submitted $3,226,012 in claims for Evaluation and Management services, according to information from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 42% rise over 2023, when providers billed $2,271,596 for the same service category.

Medicaid functions as a public health insurance initiative operated by individual states and financed with funding from both federal and state sources. The program provides coverage for low-income individuals and families, seniors, children, and people with disabilities, making it one of the largest components of the U.S. health system.

Because taxpayer dollars support Medicaid, variance in local billing demonstrates how public healthcare funding is distributed within communities.

The “Evaluation and Management” category is defined as a segment of Medicaid-billed services, grouped by care type based on standard HCPCS and CPT code prefixes and ranges. For this analysis, each billing code was associated with one service category to organize services by type without duplication and to preserve accurate comparisons over time.

Despite broader Medicaid payment increases across several categories, Evaluation and Management ranked third among Medicaid service groups by total payment amount in Daly City during 2024.

Statewide, the Evaluation and Management group placed second overall for total Medicaid spending in California in 2024.

Between 2019 and 2024, Daly City’s Medicaid payments to the Evaluation and Management category grew by $1,867,643—an increase of 137.5%. The fastest growth was observed during certain intervals, with especially significant single-year increases occurring in 2023 and 2022.

Distribution of spending for Evaluation and Management services was present throughout Daly City, but payments were primarily focused in a few ZIP codes. In 2024, ZIP code 94015 accounted for $3,207,755 and 94014 represented $18,255 in related Medicaid claims. Together, these two ZIP codes constituted all Medicaid payments for this category in Daly City for the year.

Spending within the Evaluation and Management group was also substantially clustered among specific billing codes.

For perspective, payments tied to Evaluation and Management services in Daly City grew 42% from 2023 to 2024. Across all Medicaid service categories in the city, the increase over this period was 2.6%.

The Centers for Medicare & Medicaid Services reported that combined federal and state Medicaid expenditures totaled approximately $871.7 billion for fiscal year 2023. This figure represented about 18% of the nation’s total health spending and is a substantial increase from the $613.5 billion spent in 2019, prior to the COVID-19 pandemic.

This surge equates to approximately 40% growth over a few years, largely due to greater enrollment and higher service use during and following the pandemic.

Federal budget legislation enacted during the Trump administration introduced considerable measures to reduce federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” passed in 2025, is expected to decrease federal Medicaid allocations by more than $1 trillion over 10 years and institutes changes like work requirements and expanded cost-sharing—both anticipated to diminish coverage and funding for certain recipients. These Congressional changes are likely to shift greater financial responsibility to states while limiting expansion of federal Medicaid assistance, even as the program serves tens of millions each year.

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.