Lemoore Medicaid Evaluation and Management payments increase 6.4% in 2024

Lemoore Medicaid providers submitted $281,792 in claims for the Evaluation and Management category in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This is a 6.4% rise from 2023, when claim totals for the same service type reached $264,874.

Medicaid is a public health insurance program managed by states and funded by both federal and state governments. It serves low-income families and individuals, seniors, children, and those with disabilities, making it a significant part of the nation’s health care system.

Since Medicaid funding is derived from taxpayers, local changes in billing levels offer insight into how health care dollars are spent in a particular area.

The Evaluation and Management category includes a range of services distinguished by the care provided, as defined by standard HCPCS and CPT code groupings. Each code was assigned to just one service category for this analysis, using consistent numeric ranges and code prefixes. This grouping ensures that related services are tracked together without double counting and maintains accurate rankings over time.

Evaluation and Management was the fourth largest category by Medicaid payments in Lemoore for 2024, even as overall Medicaid spending rose across numerous service groups.

Statewide in California, Evaluation and Management was the second highest category for total Medicaid payments in 2024.

Between 2019 and 2024, Medicaid payments for Evaluation and Management in Lemoore grew by $168,074, or 37.4%. Certain years, including 2020 and 2021, saw particularly sharp increases.

While these payments were made throughout Lemoore, they were mainly concentrated in a few ZIP codes. In 2024, ZIP code 93245 reported the highest Medicaid Evaluation and Management payments, with $281,792. The top ZIP code accounted for 100% of the city’s Medicaid spending in this service category for the year.

A small number of billing codes made up the majority of Medicaid payments in the Evaluation and Management category.

The 6.4% increase in Medicaid payments for Evaluation and Management services in Lemoore from 2023 to 2024 compared with a 5.6% increase across all Medicaid claim types locally over the same period.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures totaled about $871.7 billion in fiscal year 2023, representing around 18% of all U.S. health spending, a significant rise from roughly $613.5 billion in 2019, before the onset of the COVID-19 pandemic.

This rise marks nearly 40% growth over just a few years, largely due to increased enrollment and greater utilization during and after the pandemic.

Recent federal legislation under the Trump administration has introduced several major proposals to cut federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid funding by more than $1 trillion over 10 years. It also introduces measures such as work requirements and increased cost-sharing, which could limit coverage and funding for certain beneficiaries. Such changes are likely to increase financial responsibility at the state level and constrain federal Medicaid growth, even as the program continues to cover millions of Americans.

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.