Wasco Medicaid providers billed $3,289,654 for Evaluation and Management services in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That total represents a 387.5% rise from 2023, when billings for these services totaled $674,839.
Medicaid is a state-run public health insurance program with joint funding from federal and state governments. The program covers low-income people and families, seniors, children, and individuals with disabilities, making it a core component of the U.S. health care system. Read more about Medicaid funding here.
Because Medicaid funding is sourced from taxpayers, fluctuations in billing at the local level indicate how public health resources are distributed within a community.
The Evaluation and Management category groups Medicaid-billed services according to the type of care provided, using standardized HCPCS and CPT code groupings. This analysis assigned each billing code to a single service category through consistent code prefixes and number ranges, ensuring related services can be reviewed together while avoiding duplicate counts and maintaining comparable service rankings across years.
While Medicaid expenditures increased for various service categories, Evaluation and Management was the second-largest by total Medicaid payments in Wasco for 2024.
Statewide in California, Evaluation and Management also ranked second for total Medicaid payments in 2024.
In the five years leading up to 2024, Wasco saw Medicaid payments for Evaluation and Management services climb $2,805,302, or 579.2%. The pace of spending growth quickened in certain years, especially in 2023 and 2021.
Although spending on Evaluation and Management care occurred throughout the city, most payments were concentrated in a few ZIP codes. In 2024, ZIP code 93280 accounted for the entire $3,289,654 billed in the Evaluation and Management category. Collectively, the top 1 ZIP code made up 100% of Medicaid payments for Evaluation and Management in Wasco during 2024.
Within this category, Medicaid spending was focused on a relatively small set of billing codes.
For context, between 2024 and 2023, Medicaid payments for Evaluation and Management rose 387.5% in Wasco, while the change across all Medicaid claim categories in the city was 67.4% during that period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures were about $871.7 billion in fiscal year 2023. That amounted to approximately 18% of all U.S. health care spending, up significantly from $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This rise represents an increase of about 40% over a few years, primarily due to greater enrollment and utilization during and after the pandemic.
Recent federal budget laws under the Trump administration introduced major proposals to limit federal Medicaid funding and change the program’s structure. The “One Big Beautiful Bill Act,” which became law in 2025, is estimated to cut more than $1 trillion in federal Medicaid spending over a decade. It also adds measures such as work requirements and expanded cost-sharing, which could reduce coverage and federal support for certain beneficiaries. These adjustments are expected to shift more of the Medicaid funding responsibility to states and potentially restrict federal Medicaid growth, even though the program continues to serve tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $484,352 | -19.3% |
| 2021 | $655,320 | 35.3% |
| 2022 | $470,714 | -28.2% |
| 2023 | $674,839 | 43.4% |
| 2024 | $3,289,654 | 387.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $9,763,094 | 62.5% |
| 2 | Evaluation and Management | $3,289,654 | 21.1% |
| 3 | Medicine Services and Procedures | $1,843,901 | 11.8% |
| 4 | Alcohol and Drug Abuse Treatment | $385,313 | 2.5% |
| 5 | Procedures / Professional Services | $242,746 | 1.6% |
| 6 | Dental Services | $48,240 | 0.3% |
| 7 | Pathology and Laboratory Procedures | $32,390 | 0.2% |
| 8 | Surgery | $10,695 | 0.1% |
| 9 | Durable Medical Equipment | $1,095 | <0.1% |
| 10 | Vision Services | $1,054 | <0.1% |
| 11 | Drugs Administered Other than Oral Method | $918 | <0.1% |
| 12 | Medical And Surgical Supplies | $382 | <0.1% |
| 13 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99309 | Sbsq nf care moderate mdm 30 | $1,680,104 | 82 |
| 99213 | Office o/p est low 20 min | $871,938 | 270 |
| 99214 | Office o/p est mod 30 min | $267,161 | 139 |
| 99308 | Sbsq nf care low mdm 20 | $170,226 | 14 |
| 98940 | Chiropract manj 1-2 regions | $81,382 | 37 |
| 99305 | 1st nf care moderate mdm 35 | $60,614 | 14 |
| 99215 | Office o/p est hi 40 min | $45,187 | 6 |
| 98941 | Chiropract manj 3-4 regions | $16,686 | 32 |
| 99204 | Office o/p new mod 45 min | $14,583 | 8 |
| 99310 | Sbsq nf care high mdm 45 | $12,916 | 11 |
| 99212 | Office o/p est sf 10 min | $11,437 | 21 |
| 99306 | 1st nf care high mdm 50 | $10,730 | 2 |
| 99307 | Sbsq nf care sf mdm 10 | $9,644 | 3 |
| 99350 | Home/res vst est high mdm 60 | $6,364 | 3 |
| 99304 | 1st nf care sf/low mdm 25 | $5,677 | 1 |
| 99345 | Home/res vst new high mdm 75 | $5,557 | 4 |
| 99394 | Prev visit est age 12-17 | $5,493 | 16 |
| 99393 | Prev visit est age 5-11 | $4,266 | 16 |
| 99395 | Prev visit est age 18-39 | $3,323 | 7 |
| 99203 | Office o/p new low 30 min | $2,369 | 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.