Medicaid Evaluation and Management payments in Half Moon Bay surge 45953.9% in 2024

In 2024, Medicaid providers in Half Moon Bay billed $381,787 for Evaluation and Management services, the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This figure represents a 45953.9% jump from 2023, when claims for the same category totaled $829.

Medicaid, a joint federal and state public health insurance program, is financed by both governmental levels. It provides coverage to low-income families, seniors, children, and individuals with disabilities, ranking as one of the largest components of the nation’s health care system.

Since Medicaid is funded by taxpayers, local billing changes reflect how these public health dollars are spent within a given community.

The “Evaluation and Management” grouping covers certain Medicaid-billed services, which are classified using set HCPCS and CPT code groups. For reporting, each code aligns to a single service category with consistent patterns, helping track similar services together and supporting accurate long-term rankings without duplicated data.

While Medicaid spending rose among several service categories, Evaluation and Management ranked third in overall Medicaid payments for Half Moon Bay in 2024.

Across California, the Evaluation and Management grouping placed second statewide for total Medicaid payments in 2024.

During the five years preceding 2024, Medicaid payments connected to the Evaluation and Management category in Half Moon Bay grew by $372,283, or 3917.1%. The pace of growth picked up at certain times, with sharp annual rises seen in 2022 and 2022.

Though spending in the Evaluation and Management category occurred throughout the city, the majority of payments concentrated in just a few ZIP codes. In 2024, ZIP code 94019 was responsible for $381,787 in this category—accounting for 100% of all related Medicaid payments in Half Moon Bay that year.

Within this service group, Medicaid payments were further focused among a select number of billing codes.

For reference, Medicaid spending tied to the Evaluation and Management category in Half Moon Bay jumped 45953.9% from 2023 to 2024. Meanwhile, total Medicaid spending across all claim categories in the city rose 12.1% during the same time frame.

The Centers for Medicare & Medicaid Services reports that combined federal and state Medicaid expenditures reached an estimated $871.7 billion in fiscal 2023. This made up roughly 18% of total national health spending, up considerably from about $613.5 billion in 2019 prior to the COVID-19 pandemic.

This growth equates to an increase of approximately 40% over a few years, driven largely by increased enrollment and use following the pandemic.

Major recent federal budget legislation during the Trump administration introduced proposals to scale back federal Medicaid funding and restructure aspects of the program. The “One Big Beautiful Bill Act,” enacted in 2025, is forecast to reduce federal Medicaid spending by more than $1 trillion over the coming decade and implements measures like work requirements and higher cost-sharing. These adjustments could reduce coverage and funding for some enrollees by shifting more costs to states and capping federal spending growth, even as Medicaid continues to serve tens of millions nationwide.

Note: HCPCS codes are provided for context within the group. Totals and rankings in this story are based on standardized categories rather than individual codes.

Details for this article come from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access source data here.