Concord sees 49.4% rise in Medicaid Evaluation and Management payments in 2024

In 2024, Medicaid providers in Concord billed a total of $10,825,136 for services within the Evaluation and Management category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 49.4% increase over 2023, when $7,246,599 was billed for these services.

Medicaid, a joint initiative run by states and funded by state and federal governments, provides coverage for low-income adults and families, seniors, children, and those with disabilities, making it a critical part of the U.S. health system.

Taxpayers fund Medicaid payments; thus, shifts in local billing offer insight into how a community allocates public dollars for health care.

The “Evaluation and Management” group consists of Medicaid-billed services defined by care type, following specific HCPCS and CPT code ranges. Each billing code for this analysis was categorized into a single service group, using consistent code patterns to ensure related services were grouped appropriately and double counting was avoided for accurate ranking history.

While Medicaid expenditures climbed across numerous categories, Evaluation and Management placed second overall in Concord for total Medicaid payments in 2024.

Statewide in California, Evaluation and Management also held the second position for Medicaid payment totals in 2024.

Over the five-year period ending in 2024, Medicaid payments for Evaluation and Management in Concord rose by $7,995,101, or 282.5%. The pace of spending growth was especially strong in certain periods, with significant yearly jumps recorded in 2023 and 2021.

Although Evaluation and Management spending was distributed across Concord, most payments were tied to just a few ZIP codes. In 2024, ZIP code 94520 accounted for $9,289,273, ZIP code 94518 billed $1,037,778, and 94519 totaled $498,084. Collectively, these three ZIP codes made up 100% of Medicaid payments for the category in the city during the year.

Within this category, a small number of individual billing codes brought in the bulk of Medicaid payments.

For additional context, Concord’s Medicaid payments tied to Evaluation and Management services increased by 49.4% compared to the year before, while all Medicaid claim categories combined saw a 7.7% rise citywide over the same timeframe.

According to the Centers for Medicare & Medicaid Services, total state and federal Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023, making up around 18% of all national health spending—an increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This growth amounts to an increase of about 40% in just a few years, largely attributed to higher enrollment and greater use of services during and after the pandemic.

Recent congressional budget measures under the Trump administration have proposed major cuts to federal Medicaid spending and structural program changes. The “One Big Beautiful Bill Act,” enacted in 2025, is forecast to reduce federal Medicaid funding by over $1 trillion over the decade and imposes new policies such as work requirements and increased cost-sharing, which could scale back coverage and resources for some recipients. These changes are expected to result in higher costs being passed to states and restrict the rate of federal Medicaid contribution growth, even as the program serves millions nationwide.

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.