Columbia Medicaid Evaluation and Management payments reach $451,842 in 2024

In 2024, Medicaid providers in Columbia submitted $451,842 in claims for Evaluation and Management services, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents a 9% increase from 2023, when claims for the same services reached $414,606.

Medicaid is a government health insurance program operated by individual states and funded through a partnership of federal and state resources. The program serves low-income individuals and families, seniors, children, and those with disabilities, making it one of the largest sections of the U.S. health care system.

Since Medicaid is funded by taxpayers, changes in local billing amounts help illustrate how public health resources are distributed within a community.

The “Evaluation and Management” classification covers a group of Medicaid-billed services categorized by the nature of care delivered, using standardized HCPCS and CPT code groupings. In this analysis, each billing code was mapped to a single service category through consistent code prefixes and number groupings, enabling related services to be reviewed together while preventing double counting and maintaining accurate rankings over time.

While overall Medicaid spending increased across several service areas, Evaluation and Management was the second-largest category by total Medicaid payments in Columbia during 2024.

Statewide in Pennsylvania, Evaluation and Management ranked as the fourth-largest Medicaid payment category in 2024.

Between 2019 and 2024, Medicaid spending for the Evaluation and Management category in Columbia grew by $383,322, or 559.4%. Payment growth accelerated in particular years, such as 2020 and 2021, showing notable annual jumps.

Although spending was distributed throughout Columbia, payments for Evaluation and Management services were highly concentrated in a small number of ZIP codes. In 2024, ZIP code 17512 accounted for $451,842 in Evaluation and Management Medicaid payments, making up 100% of the category’s total Medicaid spending in Columbia for the year.

Within Evaluation and Management, a limited set of individual billing codes represented the majority of Medicaid payments.

Comparing changes over time, Medicaid payments for Evaluation and Management services in Columbia rose by 9% between 2024 and 2023, while total Medicaid claims across all categories saw a 4.6% increase during that period.

According to the Centers for Medicare & Medicaid Services, total state and federal Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023. This made up nearly 18% of total national health spending, marking a significant rise from around $613.5 billion in 2019, prior to the COVID-19 pandemic.

The difference amounts to about 40% growth in only a few years, largely due to increased enrollment and greater use of services during and after the pandemic period.

Federal budget legislation signed during the Trump administration has included significant changes to Medicaid funding and structure. For instance, the “One Big Beautiful Bill Act” signed into law in 2025 is projected to cut federal Medicaid spending by over $1 trillion over 10 years, while implementing work requirements and increased cost-sharing that could lower coverage and financing for some enrollees. These reforms are expected to shift more responsibility to states and slow the expansion of federal Medicaid financial support, even as the program continues to serve millions of Americans.

Note: HCPCS codes are included for reference within this category. Category totals and rankings in this article are calculated based on standardized service groupings, not by individual billing codes.

Information in this article is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the original data here.