In 2024, Medicaid providers in Taft billed $1,502,939 for services within the Evaluation and Management category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 103.1% rise compared with 2023, when providers billed $740,175 for the same services.
Medicaid is a state-administered public health insurance program, financed collaboratively by federal and state governments. It serves low-income people and families, as well as seniors, children, and individuals with disabilities, making it a major component of the U.S. health care landscape.
Since Medicaid payments are funded by taxpayers, local billing trends reflect how public health care resources are distributed within a community.
The Evaluation and Management category encompasses a set of Medicaid-billed services that are defined by the nature of care delivered, organized by standardized HCPCS and CPT code groupings. For this analysis, each billing code was sorted into a single service group based on established code prefixes and number ranges, enabling a unified look at related services and avoiding double counting, while maintaining accurate historical comparisons.
While Medicaid spending grew in several service groups, Evaluation and Management was the second-highest category in Taft by total Medicaid payments for 2024.
Statewide in California, Evaluation and Management also ranked second in total Medicaid payments for 2024.
Between 2019 and 2024, Medicaid payments tied to the Evaluation and Management category in Taft grew by $1,056,528—a 236.7% increase. The pace of spending rose during specific years, with strong annual gains in both 2021 and 2022.
Though Evaluation and Management spending was spread citywide, payments were concentrated in a few ZIP codes. In 2024, ZIP code 93268 alone accounted for $1,502,938 in Medicaid payments for the category, representing 100% of such payments in Taft that year.
Within Evaluation and Management, a small set of billing codes comprised the majority of the Medicaid payments.
To compare, Evaluation and Management-linked Medicaid payments in Taft were up 103.1% from 2023 to 2024, outpacing the 22.4% change seen across all local Medicaid claim categories for the same period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending reached about $871.7 billion in fiscal year 2023, making up around 18% of total national health expenditures. This figure rose sharply from $613.5 billion in 2019, prior to the COVID-19 pandemic.
The rise represents almost 40% growth over several years, driven mainly by higher enrollment and increased care utilization in the period during and following the pandemic.
Recent federal budgets enacted under the Trump administration included major proposals to reduce federal Medicaid funding and make structural changes to the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by over $1 trillion over 10 years and applies provisions such as work requirements and greater cost-sharing, potentially limiting access and funding for some enrollees. These policy changes may place more cost responsibility on states and limit the growth of federal Medicaid support, even as the program remains a crucial safety net for millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $446,411 | -56.6% |
| 2021 | $764,072 | 71.2% |
| 2022 | $842,519 | 10.3% |
| 2023 | $740,175 | -12.1% |
| 2024 | $1,502,938 | 103.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $5,392,744 | 70.1% |
| 2 | Evaluation and Management | $1,502,938 | 19.5% |
| 3 | Procedures / Professional Services | $304,285 | 4% |
| 4 | Medicine Services and Procedures | $278,619 | 3.6% |
| 5 | Pathology and Laboratory Procedures | $189,682 | 2.5% |
| 6 | Radiology Procedures | $21,694 | 0.3% |
| 7 | Drugs Administered Other than Oral Method | $5,699 | 0.1% |
| 8 | Durable Medical Equipment | $2,519 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $1,148,036 | 190 |
| 99214 | Office o/p est mod 30 min | $298,484 | 65 |
| 99212 | Office o/p est sf 10 min | $19,493 | 21 |
| 99395 | Prev visit est age 18-39 | $12,419 | 8 |
| 99396 | Prev visit est age 40-64 | $8,835 | 5 |
| 98940 | Chiropract manj 1-2 regions | $7,151 | 18 |
| 99173 | Visual acuity screen | $1,894 | 40 |
| 99394 | Prev visit est age 12-17 | $1,775 | 11 |
| 98941 | Chiropract manj 3-4 regions | $1,750 | 5 |
| 99215 | Office o/p est hi 40 min | $1,509 | 1 |
| 99393 | Prev visit est age 5-11 | $1,442 | 14 |
| 99188 | App topical fluoride varnish | $129 | 2 |
| 99000 | Specimen handling office-lab | $14 | 15 |
| 99202 | Office o/p new sf 15 min | $0 | 3 |
| 99381 | Init pm e/m new pat infant | $0 | 1 |
| 99391 | Per pm reeval est pat infant | $0 | 26 |
| 99392 | Prev visit est age 1-4 | $0 | 25 |
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.
