Evaluation and Management Medicaid payments in Halfway up 52.5% in 2024

According to the U.S. Department of Health and Human Services Medicaid Provider Spending database, Medicaid providers in Halfway billed $11,155 for Evaluation and Management services in 2024. This represents a 52.5% increase from 2023, when providers billed $7,315 for the same services.

Medicaid is a state-administered public health insurance program funded jointly by federal and state governments. The program covers low-income individuals and families, seniors, children, and people with disabilities, making it one of the largest components of the U.S. health care system.

Because taxpayer dollars support Medicaid, shifts in local Medicaid billing reveal how public health care resources are allocated in a community.

The “Evaluation and Management” category represents a set of Medicaid-billed services defined by the type of care delivered, based on standardized groupings of HCPCS and CPT codes. For this analysis, each code was grouped into a single service category using set code prefixes and numeric ranges, helping to assess related services as a whole, avoid double counting, and maintain accurate rankings over time.

While spending increased in multiple Medicaid service categories, Evaluation and Management led Halfway by total Medicaid payments in 2024.

Similarly, Evaluation and Management was the top-ranked Medicaid payment category statewide in Oregon for 2024.

Between 2019 and 2024, Medicaid payments for Evaluation and Management services in Halfway rose by $5,537, or 98.6%. Some years, such as 2022 and 2020, saw especially strong year-over-year growth.

Even though payments for Evaluation and Management services were distributed throughout Halfway, most were concentrated in a small number of ZIP codes. In 2024, ZIP code 97834 accounted for $11,154 in Medicaid payments for Evaluation and Management, with the top 1 ZIP code making up 100% of the city’s total in this category for the year.

Within this category, Medicaid payments were highly concentrated among a few specific billing codes.

For comparison, Medicaid payments for Evaluation and Management in Halfway rose 52.5% from 2023 to 2024, while all Medicaid claim categories in the city saw a 51.1% increase over the same period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached approximately $871.7 billion during fiscal year 2023, amounting to about 18% of all national health expenses—rising sharply from about $613.5 billion in 2019, prior to the COVID-19 pandemic.

That increase equals about 40% growth over several years, largely driven by rising enrollment and higher service use during and after the pandemic era.

Recent federal budget legislation enacted under the Trump administration brought significant proposals to reduce federal Medicaid funding and change the program’s structure. The “One Big Beautiful Bill Act,” signed in 2025, is expected to cut over $1 trillion from federal Medicaid spending over 10 years and includes provisions such as work requirements and increased cost-sharing, which could reduce coverage and funding for certain participants. These measures are forecast to shift more costs to states and slow the growth of federal Medicaid aid, even as the program continues serving tens of millions of Americans.

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.