In 2024, Medicaid providers in High Point billed $16,406,456 for Evaluation and Management services, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This amount represents an 11.3% increase from 2023, when $14,736,993 was billed for the same category.
Medicaid is a state-administered public health insurance program that is jointly financed by federal and state governments. The program provides coverage for low-income residents, children, older adults, and those with disabilities, making it a major component of the nation’s health care system.
Since Medicaid funding comes from taxpayers, local shifts in billing patterns illustrate how a community allocates public health dollars.
The “Evaluation and Management” group includes Medicaid services classified by the kind of care given, following the standardized HCPCS and CPT code groupings. The analysis assigned each billing code to a designated service group using uniform code prefixes and numeric ranges, streamlining the review of related services and preventing duplication to ensure reliable ranking over time.
Though Medicaid spending increased in several service groups, Evaluation and Management led all categories in High Point by total Medicaid payments in 2024.
Statewide in North Carolina, Evaluation and Management ranked as the second-highest Medicaid payment category for the year.
Over the five years prior to 2024, payments associated with Evaluation and Management in High Point climbed by $10,450,196, or 175.4%. Certain years, including 2021 and 2022, saw significant year-over-year gains in this category.
While funds for Evaluation and Management were distributed citywide, a small number of ZIP codes accounted for most payments. In 2024, the ZIP codes with the largest payments in this category were 27262, at $9,790,990; 27265, at $5,846,036; and 27263, at $586,420. Together, these 3 ZIP codes made up 98.9% of all Medicaid payments for Evaluation and Management services in High Point that year.
Within Evaluation and Management, Medicaid payments were distributed mainly among a select group of individual billing codes.
In High Point, Medicaid payments linked to the category grew 11.3% from 2023 to 2024, compared to a 7.2% increase for all Medicaid claim categories in the city during the same span.
The Centers for Medicare & Medicaid Services reported that combined federal and state Medicaid expenditures came to about $871.7 billion in fiscal year 2023, making up nearly 18% of all national health spending. That’s up sharply from $613.5 billion in 2019, before the COVID-19 pandemic.
This jump shows roughly 40% growth in a brief period, primarily because of expanded eligibility and increased use during and after the pandemic.
Recent federal budget laws under the Trump administration have brought forward sweeping proposals to cut federal Medicaid funding and overhaul the program. For example, the “One Big Beautiful Bill Act,” became law in 2025 and is set to reduce federal Medicaid support by over $1 trillion in the next decade. The law includes new policies like work requirements and greater cost-sharing, which could lead to reduced coverage and funding for certain groups. These adjustments are anticipated to push more costs onto states and restrict growth in federal Medicaid resources, while the program continues to serve tens of millions of people in the United States.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $5,956,259 | -14.2% |
| 2021 | $10,391,915 | 74.5% |
| 2022 | $13,434,884 | 29.3% |
| 2023 | $14,736,993 | 9.7% |
| 2024 | $16,406,456 | 11.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $16,406,456 | 39% |
| 2 | Medicine Services and Procedures | $7,681,859 | 18.3% |
| 3 | Alcohol and Drug Abuse Treatment | $7,558,972 | 18% |
| 4 | National Codes Established for State Medicaid Agencies | $3,350,982 | 8% |
| 5 | Pathology and Laboratory Procedures | $2,263,697 | 5.4% |
| 6 | Dental Services | $2,182,612 | 5.2% |
| 7 | Durable Medical Equipment | $627,784 | 1.5% |
| 8 | Surgery | $483,272 | 1.2% |
| 9 | Procedures / Professional Services | $400,357 | 1% |
| 10 | Radiology Procedures | $339,588 | 0.8% |
| 11 | Temporary National Codes (Non-Medicare) | $167,014 | 0.4% |
| 12 | Enteral and Parenteral Therapy | $139,272 | 0.3% |
| 13 | Ambulance and Other Transport Services and Supplies | $127,884 | 0.3% |
| 14 | Medical And Surgical Supplies | $102,176 | 0.2% |
| 15 | Anesthesia | $67,363 | 0.2% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $59,501 | 0.1% |
| 17 | Temporary Codes | $26,588 | 0.1% |
| 18 | Drugs Administered Other than Oral Method | $19,858 | <0.1% |
| 19 | Orthotic Procedures and services | $8,090 | <0.1% |
| 20 | Administrative, Miscellaneous and Investigational | $709 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $4,122,009 | 1,229 |
| 99199 | Unlisted special svc px/rprt | $3,531,599 | 306 |
| 99284 | Emergency dept visit mod mdm | $1,838,753 | 174 |
| 99213 | Office o/p est low 20 min | $1,672,095 | 800 |
| 99285 | Emergency dept visit hi mdm | $1,052,920 | 107 |
| 99283 | Emergency dept visit low mdm | $1,038,343 | 154 |
| 99204 | Office o/p new mod 45 min | $577,967 | 210 |
| 99392 | Prev visit est age 1-4 | $300,519 | 170 |
| 99391 | Per pm reeval est pat infant | $231,842 | 145 |
| 99393 | Prev visit est age 5-11 | $222,061 | 126 |
| 99309 | Sbsq nf care moderate mdm 30 | $218,967 | 30 |
| 99215 | Office o/p est hi 40 min | $204,771 | 39 |
| 99233 | Sbsq hosp ip/obs high 50 | $179,487 | 117 |
| 99223 | 1st hosp ip/obs high 75 | $173,902 | 89 |
| 99394 | Prev visit est age 12-17 | $135,952 | 63 |
| 99349 | Home/res vst est mod mdm 40 | $124,269 | 55 |
| 99348 | Home/res vst est low mdm 30 | $87,213 | 38 |
| 99205 | Office o/p new hi 60 min | $72,548 | 16 |
| 99203 | Office o/p new low 30 min | $67,698 | 36 |
| 99239 | Hosp ip/obs dschrg mgmt >30 | $65,526 | 83 |
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.
