Pleasant Garden Medicaid Evaluation and Management payments climb to $92,124 in 2024

In 2024, Medicaid providers in Pleasant Garden billed $92,124 for services under the Evaluation and Management category, as detailed by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total marks a 51.5% rise from 2023, when claims submitted for the same services reached $60,819.

Medicaid is a public health insurance program administered by states with joint funding from federal and state governments. The program offers coverage to low-income individuals and families, seniors, children and people with disabilities, making it a major component of the U.S. health care system.

Since Medicaid operates with taxpayer funding, local shifts in billing provide insight into the community’s public health expenditure distribution.

The “Evaluation and Management” grouping consists of Medicaid services defined by care type and identified through standardized HCPCS and CPT code ranges. This analysis assigned each billing code to a single service category with standardized prefixes and ranges, allowing related services to be grouped without duplication and to sustain accurate rankings year to year.

Although Medicaid expenditures rose in several categories, Evaluation and Management ranked as the second highest in Pleasant Garden by total payments in 2024.

Statewide in North Carolina, Evaluation and Management also placed second for Medicaid payments in 2024.

Over the five-year span ending in 2024, Evaluation and Management Medicaid payments in Pleasant Garden increased by $51,267, equating to a 125.5% gain. The rate of growth accelerated during some intervals, with significant year-over-year jumps seen in 2021 and 2022.

The city’s Evaluation and Management spending was spread across Pleasant Garden, but primarily concentrated in a few ZIP codes. For 2024, ZIP code 27313 led with $92,123, which accounted for 100% of Medicaid payments in this service category for Pleasant Garden that year.

Within the Evaluation and Management category, Medicaid spending largely centered around a limited selection of billing codes.

By comparison, Evaluation and Management Medicaid payments rose 51.5% in Pleasant Garden from 2023 to 2024, while overall Medicaid claim categories in the city saw a 34.5% increase for the same timeframe.

According to the Centers for Medicare & Medicaid Services, total Medicaid spending by both federal and state entities amounted to about $871.7 billion for fiscal year 2023. This sum comprised around 18% of national health expenditures, rising significantly from approximately $613.5 billion in 2019, before the onset of the COVID-19 pandemic.

This represents about 40% growth in a span of a few years, driven mostly by expanded Medicaid numbers and increased service utilization during and following the pandemic.

Federal budget policy in recent years under the Trump administration has contained extensive proposals shrinking federal Medicaid support and reshaping the program. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to cut federal Medicaid spending by over $1 trillion across a decade and brings in measures like work requirements and higher cost-sharing. These changes may reduce coverage and limit funding for some recipients, with associated costs increasingly shifting to states, despite the program still covering 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.