Reinholds Medicaid payments for evaluation and management services reach $50,693 in 2024

In 2024, Medicaid providers in Reinholds billed $50,693 for services included in the Evaluation and Management category, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 4.1% rise from 2023, when claims for the category totaled $48,698.

Medicaid operates as a public health insurance initiative managed by states and funded through a federal-state partnership. The program provides coverage for low-income groups, seniors, children, and individuals with disabilities, making it a major component of health care in the United States.

Since Medicaid draws on taxpayer funding, fluctuations in local billing demonstrate how public health expenditures are distributed at the community level.

The “Evaluation and Management” category encompasses a set of Medicaid-billed services identified by the nature of care delivered, using designated HCPCS and CPT code sets. For this report, codes were grouped by category through standardized prefixes and numerical ranges, ensuring related services could be analyzed collectively, avoiding duplicate counts and maintaining accurate rankings longitudinally.

Though overall Medicaid spending increased among several categories, Evaluation and Management was the top-ranked category by total payments in Reinholds in 2024.

On a statewide basis in Pennsylvania, Evaluation and Management came in fourth by total Medicaid payments during 2024.

Between 2019 and 2024, Medicaid payments for the Evaluation and Management category in Reinholds rose by $42,031, marking 485.2% growth. Certain years saw accelerated spending, most notably in 2021 and 2022.

While care in the Evaluation and Management category was accessed throughout the city, payments were heavily concentrated in a small number of ZIP codes. In 2024, ZIP code 17569 alone received $50,692 in Medicaid payments for these services, representing the entirety of such payments in Reinholds that year.

Within this category, most Medicaid payments were linked to a select group of specific billing codes.

Comparing performance, Medicaid payments for the Evaluation and Management category climbed 4.1% between 2024 and 2023 in Reinholds, matching the 4.1% overall increase across all Medicaid claim types citywide during the same timeframe.

Centers for Medicare & Medicaid Services data show that combined state and federal Medicaid spending totaled about $871.7 billion in the 2023 fiscal year. This made up roughly 18% of national health expenditures, compared with $613.5 billion in 2019, prior to the COVID-19 pandemic.

This translates to a roughly 40% increase within a few years, driven mainly by increased enrollment and service use during and following the pandemic period.

Recent federal budget measures from the Trump administration have proposed significant reductions to federal Medicaid funding and changes to the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is estimated to reduce federal Medicaid expenditures by more than $1 trillion over 10 years, with provisions such as work mandates and higher cost-sharing, potentially decreasing coverage and funding for part of the beneficiary population. These adjustments are likely to move additional costs to the states and put limits on federal Medicaid growth, although the program remains a primary payer for many 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.