Evaluation and Management Medicaid payments in Baileyton climb 26.8% to $60,905 in 2024

In 2024, Baileyton Medicaid providers billed $60,905 for Evaluation and Management services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represented a 26.8% increase over 2023, when the total for the same service category was $48,021.

Medicaid, the public health insurance program administered by individual states and supported through both federal and state funding, serves low-income individuals and families, the elderly, children, and people with disabilities. This program is one of the largest components of the U.S. health care system.

Since Medicaid disbursements are funded by taxpayers, variations in local billing highlight how health care resources are used within a community.

The Evaluation and Management category encompasses a range of Medicaid-billed services grouped by care type, based on consistent HCPCS and CPT code groupings. Each billing code was classified into a single service type using set code prefixes and number ranges for this analysis, allowing related services to be reviewed together, minimizing duplicate counting, and ensuring accurate ranking year-over-year.

While Medicaid spending grew across several service types, Evaluation and Management services generated the highest amount of Medicaid payments in Baileyton in 2024.

Statewide in Alabama, Evaluation and Management was the second highest category by total Medicaid payments in 2024.

Between 2019 and 2024, Baileyton’s Medicaid payments for Evaluation and Management services increased by $20,536, or 50.9%. Some years saw stronger increases, especially in 2020 and 2021, reflecting periods of more rapid growth in spending.

Medicaid spending for Evaluation and Management care was distributed citywide, but most payments were concentrated in specific ZIP codes. In 2024, ZIP code 35019 accounted for $60,905 in Medicaid payments for this category, representing 100% of such payments in Baileyton for the year.

Payments within the Evaluation and Management group also centered around a small number of individual billing codes.

During the same period, Medicaid payments for Evaluation and Management services in Baileyton rose 26.8% from 2023 to 2024, compared to a 16.2% increase across all Medicaid claim categories in the city.

The Centers for Medicare & Medicaid Services reports that combined state and federal Medicaid costs reached around $871.7 billion in fiscal year 2023, comprising approximately 18% of total national health spending, which was a significant jump from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This surge amounts to a roughly 40% increase over several years, mainly due to greater enrollment and utilization during and after the pandemic.

Recent federal budget measures under the Trump administration have included significant proposals to trim federal Medicaid funding and revise the program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by over $1 trillion in the next decade and introduces new requirements such as work mandates and greater cost-sharing, which could decrease coverage and funding for some beneficiaries. These changes are likely to shift additional responsibilities to states and slow federal Medicaid budget growth, even as the program continues to cover tens of millions 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.