In 2024, Grandview Medicaid providers billed $624,513 for services under the Evaluation and Management classification, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflected a 1.8% rise from 2023, when billing for the same category totaled $613,368.
Medicaid is a public health insurance option administered by states and funded by both federal and state governments. It serves low-income residents, older adults, children, and people with disabilities, making it one of the nation’s largest health care programs.
Because taxpayer dollars finance Medicaid, changes in billing highlight the allocation of public health care funding in local communities.
The “Evaluation and Management” service group includes a set of Medicaid-billed services categorized according to provided care and defined by specific HCPCS and CPT code ranges. For this study, each billing code was exclusively assigned to a service group based on consistent code prefixes and numeric spans. This methodology enables like services to be compared together and maintains accurate year-over-year rankings by preventing duplication.
Despite increases across numerous Medicaid categories, Evaluation and Management placed third in Grandview for total Medicaid payments in 2024.
Statewide in Washington, Evaluation and Management was the second largest Medicaid payment category for the year.
Between 2019 and 2024, Grandview’s Medicaid payments tied to Evaluation and Management rose a total of $273,197, marking a 77.8% increase. The pace of this growth was especially strong in select years, such as 2022 and 2021, when sharp annual gains occurred.
Although evaluation and management spending was distributed across Grandview, most payments were focused within a small number of ZIP codes. During 2024, ZIP code 98930 generated $624,512 in Medicaid payments under this category. The top listed ZIP code represented 100% of Grandview’s Medicaid payments in this grouping for the year.
Medicaid payments within Evaluation and Management also concentrated among a select set of individual codes.
For context, Medicaid payments in the Evaluation and Management category in Grandview rose 1.8% from 2023 to 2024, compared with a 5.8% shift seen across all Medicaid services locally during that time frame.
According to the Centers for Medicare & Medicaid Services, combined federal and state spending for Medicaid totaled around $871.7 billion in fiscal 2023, accounting for roughly 18% of all national health expenditures. That figure sharply increased from $613.5 billion in 2019, before the COVID-19 pandemic.
This upward trend equals growth of approximately 40% in just a few years, fueled primarily by rising enrollment and service utilization during and after the pandemic.
Recent federal budget acts under the Trump administration have introduced notable proposals to reduce federal Medicaid appropriations and adjust how the program operates. The “One Big Beautiful Bill Act,” signed in 2025, is slated to reduce federal Medicaid spending by over $1 trillion over 10 years and add requirements such as work mandates and higher out-of-pocket costs for some participants. These measures are anticipated to transfer additional costs to states and put constraints on future federal Medicaid growth, while the program continues to serve tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $351,315 | -8.6% |
| 2021 | $439,836 | 25.2% |
| 2022 | $561,880 | 27.7% |
| 2023 | $613,367 | 9.2% |
| 2024 | $624,512 | 1.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $4,129,258 | 67.3% |
| 2 | Medicine Services and Procedures | $711,599 | 11.6% |
| 3 | Evaluation and Management | $624,512 | 10.2% |
| 4 | Dental Services | $518,545 | 8.4% |
| 5 | Alcohol and Drug Abuse Treatment | $123,593 | 2% |
| 6 | Procedures / Professional Services | $16,140 | 0.3% |
| 7 | Pathology and Laboratory Procedures | $11,598 | 0.2% |
| 8 | Radiology Procedures | $2,898 | <0.1% |
| 9 | Surgery | $891 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $221,891 | 213 |
| 99213 | Office o/p est low 20 min | $208,571 | 223 |
| 99215 | Office o/p est hi 40 min | $80,432 | 9 |
| 98941 | Chiropract manj 3-4 regions | $42,530 | 12 |
| 99391 | Per pm reeval est pat infant | $24,459 | 28 |
| 99202 | Office o/p new sf 15 min | $13,774 | 11 |
| 99392 | Prev visit est age 1-4 | $10,995 | 24 |
| 99205 | Office o/p new hi 60 min | $7,706 | 4 |
| 99393 | Prev visit est age 5-11 | $5,301 | 21 |
| 99212 | Office o/p est sf 10 min | $3,042 | 9 |
| 99394 | Prev visit est age 12-17 | $2,806 | 15 |
| 99204 | Office o/p new mod 45 min | $2,250 | 1 |
| 99381 | Init pm e/m new pat infant | $749 | 3 |
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.
