Pixley Medicaid spending for evaluation and management services climbs to $492,354 in 2024

Pixley’s Medicaid providers reported billing $492,354 for services in the Evaluation and Management category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount rose 6.7% compared with 2023, when $461,647 in claims were filed for the same category.

Medicaid, a public health insurance program managed by states and jointly financed by federal and state funds, covers eligible low-income people, seniors, children, and individuals with disabilities. The program is a major component of the U.S. health care system.

Fluctuations in Medicaid payments, funded by taxpayers, highlight how public health care resources are distributed within communities.

The Evaluation and Management classification includes a selection of Medicaid-billed services identified by the type of care provided and organized using standardized HCPCS and CPT code parameters. For this reporting, each billing code was grouped under a single service type with consistent code prefixes and ranges to ensure related services are considered together, minimizing double counting and maintaining accurate tracking over time.

While Medicaid funding increased across multiple service types, Evaluation and Management was the second-highest category for Medicaid payments in Pixley for 2024.

Evaluation and Management also ranked second in total Medicaid payments statewide in California for 2024.

During the five-year span leading up to 2024, Medicaid payments for Evaluation and Management services in Pixley grew by $127,892, representing a 35.1% rise. Periods of especially strong annual growth were recorded in 2021 and 2020.

Although Evaluation and Management spending was distributed across Pixley, the majority occurred within just a small number of ZIP codes. The ZIP code 93256 saw Medicaid payments in this category reach $492,353 in 2024, accounting for 100% of Pixley’s Evaluation and Management-related Medicaid payments that year.

A handful of specific billing codes received the largest amounts of Medicaid payments within the Evaluation and Management category.

Between 2023 and 2024, Pixley’s Medicaid payments for Evaluation and Management services rose by 6.7%. Across all Medicaid claim categories during the same period in the city, payments changed by 16.9%.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending combined to reach approximately $871.7 billion in fiscal 2023, which is about 18% of total national health expenditures. That is a significant increase from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.

This jump marks growth of close to 40% over a few years, largely influenced by expanded Medicaid rolls and increased usage during and after the pandemic period.

Recent U.S. federal budget measures under the Trump administration have included major proposals for reducing federal Medicaid contributions and changing program requirements. Notably, the “One Big Beautiful Bill Act,” signed into law in 2025, is expected to cut more than $1 trillion in federal Medicaid support over 10 years, while implementing policies like work requirements and higher cost-sharing. These steps could lower coverage and funding for certain recipients and are anticipated to increase states’ fiscal responsibilities, even as the program continues to serve 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.