Anaheim Medicaid Evaluation and Management service payments reach $37,392,965 in 2024

In 2024, providers in Anaheim billed $37,392,965 to Medicaid for services classified within the Evaluation and Management category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This total reflected a 96.7% jump compared with 2023, when $19,006,470 was billed for these services.

Medicaid is a public insurance initiative run by states and funded collectively by federal and state governments. The program provides coverage to low-income families and individuals, seniors, children and those with disabilities, making it a major component of the U.S. health care system.

Local fluctuations in Medicaid billing illustrate how taxpayer-funded health care dollars are utilized in each community.

The “Evaluation and Management” category groups Medicaid services by the type of care, using standardized HCPCS and CPT code sets. In compiling this analysis, each code was consistently classified within a single service group by examining code prefixes and number ranges to provide accurate year-over-year comparisons and avoid double counting.

Spending in multiple Medicaid categories rose, but Evaluation and Management led all categories in Anaheim for total Medicaid payments in 2024.

Statewide in California, Evaluation and Management was the second-largest Medicaid service category by total payments for 2024.

Between 2019 and 2024, Evaluation and Management Medicaid payments in Anaheim increased by $27,052,035, or a 261.6% gain. Spending surged in select years, notably in 2021 and 2023.

Within Anaheim, Evaluation and Management claims were not evenly distributed but concentrated in certain ZIP codes. In 2024, ZIP code 92806 saw $13,243,740 in Medicaid payments tied to this category. ZIP code 92801 reported $9,199,501, while 92807 recorded $6,252,306. Taken together, these 3 ZIP codes made up 76.7% of Anaheim’s Evaluation and Management Medicaid billing for the year.

Only a small portion of billing codes accounted for the bulk of Medicaid pay-outs in the Evaluation and Management category.

Comparatively, the 96.7% increase from 2023 to 2024 in Anaheim’s Evaluation and Management Medicaid spending far outpaced the 31% change observed for all Medicaid claim categories in the city over that period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures totaled about $871.7 billion in fiscal year 2023, making up nearly 18% of all national health spending. This was a significant climb from the roughly $613.5 billion seen in 2019, before the COVID-19 pandemic.

That reflected an increase of nearly 40% within just a few years, largely attributed to increased enrollment and utilization during and after the pandemic.

Recent federal budget actions under the Trump administration have included notable moves to reduce federal Medicaid outlays and revise program structure. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to ultimately cut over $1 trillion in federal Medicaid spending over 10 years, introducing changes such as work requirements and higher cost-sharing that could reduce benefits and funding for certain groups. This is likely to result in increased financial responsibility for states and may restrain future federal support, even as Medicaid continues serving 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.