Medicaid providers in Redwood City billed $8,006,582 for services grouped under the Evaluation and Management category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents a 171.2% jump compared to 2023, when claims for the same service type reached $2,951,795.
Medicaid, a health coverage program overseen by states and funded both federally and by states, serves low-income individuals, families, seniors, children, and people with disabilities. It is one of the largest U.S. health care programs.
Because Medicaid is taxpayer-funded, fluctuations in local billing show how public health care funding is distributed in each community.
The Evaluation and Management category encompasses Medicaid-billed services that are grouped by care type, drawn from consistent HCPCS and CPT code ranges. In this study, billing codes were individually classified within a single service category to track related services together, eliminate duplicate counts, and maintain accurate category rankings over time.
While Medicaid expenditures rose in several service groups, Evaluation and Management stood as the third-highest Medicaid payment category in Redwood City for 2024.
Evaluation and Management was also the second-leading Medicaid payment category in California for the same year.
Looking at the five years ahead of 2024, Medicaid Evaluation and Management payments in Redwood City grew by $7,269,150, representing a 985.7% increase. Certain periods saw heightened growth, including notable annual upticks during 2023 and 2021.
Evaluation and Management care payments were distributed citywide but concentrated in a few ZIP codes. In 2024, ZIP code 94063 recorded $6,476,011 in Medicaid payments, followed by 94062 with $866,985, and 94061 with $661,858. Collectively, these 3 ZIP codes represented all Medicaid spending for Evaluation and Management in Redwood City that year.
Medicaid payments within the Evaluation and Management group were focused on a select set of billing codes.
Between 2024 and 2023, Medicaid spending for Evaluation and Management in Redwood City climbed 171.2%, while all Medicaid claim categories citywide increased 10.5% over the same time frame.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures totaled roughly $871.7 billion in the 2023 fiscal year. This made up about 18% of the nation’s health care spending, up sharply from $613.5 billion in 2019, preceding the COVID-19 pandemic.
This rise marks nearly 40% growth over several years, mainly due to increased enrollment and usage during and after the pandemic.
Recent federal budget policy from the Trump administration has introduced major recommendations to shrink federal Medicaid support and alter the structure of the program. The “One Big Beautiful Bill Act,” which became law in 2025, is expected to reduce federal Medicaid spending by over $1 trillion in the next ten years and include measures such as work requirements and higher cost-sharing, potentially affecting coverage and funding for specific beneficiaries. These adjustments are likely to increase state obligations and limit federal Medicaid growth, even as millions of Americans remain served by the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $737,432 | -21.4% |
| 2021 | $1,079,542 | 46.4% |
| 2022 | $1,128,715 | 4.6% |
| 2023 | $2,951,795 | 161.5% |
| 2024 | $8,006,581 | 171.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Pathology and Laboratory Procedures | $14,039,043 | 32.9% |
| 2 | National Codes Established for State Medicaid Agencies | $9,696,599 | 22.7% |
| 3 | Evaluation and Management | $8,006,581 | 18.8% |
| 4 | Medicine Services and Procedures | $4,943,012 | 11.6% |
| 5 | Alcohol and Drug Abuse Treatment | $2,862,518 | 6.7% |
| 6 | Dental Services | $1,099,879 | 2.6% |
| 7 | Radiology Procedures | $1,062,954 | 2.5% |
| 8 | Procedures / Professional Services | $520,330 | 1.2% |
| 9 | Anesthesia | $164,841 | 0.4% |
| 10 | Drugs Administered Other than Oral Method | $137,910 | 0.3% |
| 11 | Surgery | $50,816 | 0.1% |
| 12 | Temporary National Codes (Non-Medicare) | $46,473 | 0.1% |
| 13 | Vision Services | $42,193 | 0.1% |
| 14 | Temporary Codes | $9,201 | <0.1% |
| 15 | Medical And Surgical Supplies | $6,128 | <0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $1,018 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99284 | Emergency dept visit mod mdm | $2,181,597 | 337 |
| 99215 | Office o/p est hi 40 min | $1,014,773 | 26 |
| 99283 | Emergency dept visit low mdm | $913,941 | 131 |
| 99285 | Emergency dept visit hi mdm | $886,009 | 124 |
| 99214 | Office o/p est mod 30 min | $863,552 | 121 |
| 99213 | Office o/p est low 20 min | $855,947 | 321 |
| 99212 | Office o/p est sf 10 min | $448,706 | 114 |
| 99282 | Emergency dept visit sf mdm | $378,304 | 44 |
| 99204 | Office o/p new mod 45 min | $129,895 | 38 |
| 99205 | Office o/p new hi 60 min | $88,343 | 13 |
| 99202 | Office o/p new sf 15 min | $61,288 | 12 |
| 99281 | Emr dpt vst mayx req phy/qhp | $50,926 | 11 |
| 99203 | Office o/p new low 30 min | $47,493 | 17 |
| 99309 | Sbsq nf care moderate mdm 30 | $32,217 | 21 |
| 99308 | Sbsq nf care low mdm 20 | $16,697 | 12 |
| 99211 | Off/op est may x req phy/qhp | $11,785 | 18 |
| 99070 | Special supplies phys/qhp | $9,604 | 32 |
| 99000 | Specimen handling office-lab | $3,330 | 13 |
| 99443 | $2,964 | 2 | |
| 98976 | Rtm dev sply resp sys 16-30d | $2,572 | 9 |
Note: HCPCS codes are listed for context within the category. Category totals and rankings cited here use standardized service groupings and do not rely on individual billing codes alone.
Data in this article was sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original source is available here.