Whiteriver Medicaid billing for Evaluation and Management climbs to $16,542,061 in 2024

In 2024, Medicaid providers in Whiteriver billed $16,542,061 for services categorized as Evaluation and Management, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. That figure marks a 5.3% increase from 2023, when claims for the same group of services totaled $15,709,827.

Medicaid, a public health insurance initiative, is jointly funded by federal and state governments and administered by the states. The program covers low-income families and individuals, seniors, children, and those with disabilities, making it one of the main pillars of the U.S. health care system. More details are available from the Commonwealth Fund.

Since Medicaid funding comes from taxpayer contributions, variations in local billing help illustrate how health care resources are distributed across communities.

The “Evaluation and Management” service group includes Medicaid-billed care types classified using standardized HCPCS and CPT code groupings. For this report, each billing code was linked to a specific service category using consistent code prefixes and ranges, which enabled grouping related services for analysis, reduced overlap, and supported accurate comparisons over time.

Medicaid spending rose in several categories, but Evaluation and Management ranked highest in total Medicaid payments in Whiteriver for 2024.

At the state level, Evaluation and Management registered as the third-highest category for Medicaid spending in Arizona during 2024.

From 2019 to 2024, Medicaid payments associated with Evaluation and Management rose by $5,640,705, or 51.7%, in Whiteriver. There were especially notable year-over-year increases during 2021 and 2022, pointing to periods of faster spending growth.

While Evaluation and Management spending was distributed citywide, payments were concentrated within a small set of ZIP codes. In 2024, ZIP code 85941 alone accounted for $16,542,060 in Medicaid payments tied to Evaluation and Management, representing 100% of such payments in Whiteriver that year.

The category also saw Medicaid payments focused within a relatively small number of billing codes.

Evaluating the pace of increase, Medicaid payments for Evaluation and Management in Whiteriver rose 5.3% from 2023 to 2024, whereas total Medicaid categories in the community collectively climbed 14.2% over the same period.

Centers for Medicare & Medicaid Services data show that federal and state Medicaid spending hit about $871.7 billion in fiscal 2023, making up roughly 18% of total U.S. health expenditures. This is a sharp increase from $613.5 billion spent in 2019, prior to the COVID-19 pandemic.

This represents approximately 40% growth in just a few years, attributed mainly to expanded enrollment and higher use of the program during and after the pandemic.

Recent federal budget laws enacted during the Trump administration include notable proposals to decrease federal Medicaid spending and change the structure of the program. The “One Big Beautiful Bill Act,” enacted in 2025, is estimated to reduce federal Medicaid outlays by more than $1 trillion over 10 years. The act also adds work requirements and greater cost-sharing, which could result in narrower coverage and funding for some beneficiaries. These measures may shift more costs to states and limit future federal Medicaid growth, even as the program serves millions nationally.

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.