In 2024, Medicaid providers in Round Mountain submitted $102,546 in claims tied to the Evaluation and Management service category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects a 24.5% growth compared with 2023, when $82,353 in claims were billed for these services.
Medicaid operates as a state-administered public health insurance program and is funded through both federal and state governments. The program covers children, seniors, people with disabilities, and low-income families, and constitutes one of the nation’s largest health care programs.
Since Medicaid funding derives from taxpayers, shifts in provider billing illustrate how health care resources are distributed within local communities.
The “Evaluation and Management” classification refers to a set of Medicaid services grouped by care type, based on standardized HCPCS and CPT codes. For this reporting, each service code was sorted into a single category using consistent prefixes and numerical groupings, ensuring related care was grouped and double counting prevented, maintaining accurate rankings across years.
Evaluation and Management was the fourth largest category by Medicaid payments in Round Mountain for 2024, despite overall spending rising in several categories.
Across California, the Evaluation and Management category ranked second in total Medicaid payments in 2024.
In the five years before 2024, Medicaid claims for Evaluation and Management services in Round Mountain grew by $60,829, or 145.8%. The rate of increase was higher in some periods, with significant annual growth recorded in both 2022 and 2023.
Payments for Evaluation and Management services were spread throughout the city, but most of the Medicaid dollars were concentrated in a few ZIP codes. In 2024, ZIP code 96084 accounted for $102,545, representing 100% of Round Mountain’s payments in this category for the year.
A small number of individual service codes drew the majority of Medicaid payments in the Evaluation and Management category.
For context, the 24.5% rise in Evaluation and Management Medicaid payments in Round Mountain between 2024 and 2023 compares to a 14.9% increase for all Medicaid claim categories in the city during the same timeframe.
According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal 2023. That total accounted for about 18% of national health spending, up sharply from $613.5 billion in 2019, prior to the COVID-19 pandemic.
The boost marks an increase of about 40% in just a few years, attributed largely to increases in enrollment and service use during and after the pandemic period.
Recent federal budget measures under the Trump administration introduced major changes affecting Medicaid funding and structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next 10 years. The legislation includes work requirements and higher cost-sharing, which could limit funding and coverage for some beneficiaries and potentially shift expenses to states, even as Medicaid continues to serve tens of millions across the country.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $41,716 | 3.3% |
| 2021 | $45,023 | 7.9% |
| 2022 | $69,672 | 54.7% |
| 2023 | $82,353 | 18.2% |
| 2024 | $102,545 | 24.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $4,277,264 | 85.9% |
| 2 | Procedures / Professional Services | $356,350 | 7.2% |
| 3 | Medicine Services and Procedures | $216,830 | 4.4% |
| 4 | Evaluation and Management | $102,545 | 2.1% |
| 5 | Pathology and Laboratory Procedures | $16,151 | 0.3% |
| 6 | Alcohol and Drug Abuse Treatment | $10,808 | 0.2% |
| 7 | Drugs Administered Other than Oral Method | $283 | <0.1% |
| 8 | Dental Services | $0 | <0.1% |
| 8 | Surgery | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $63,829 | 71 |
| 98940 | Chiropract manj 1-2 regions | $28,652 | 12 |
| 99213 | Office o/p est low 20 min | $8,746 | 57 |
| 99393 | Prev visit est age 5-11 | $306 | 6 |
| 99392 | Prev visit est age 1-4 | $299 | 3 |
| 99203 | Office o/p new low 30 min | $240 | 2 |
| 99394 | Prev visit est age 12-17 | $219 | 2 |
| 98941 | Chiropract manj 3-4 regions | $201 | 3 |
| 99283 | Emergency dept visit low mdm | $50 | 8 |
| 99173 | Visual acuity screen | $0 | 9 |
| 99215 | Office o/p est hi 40 min | $0 | 2 |
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.
