Walnut Creek Medicaid spending on Evaluation and Management services climbs to $15.9 million in 2024

In 2024, Medicaid providers in Walnut Creek billed $15,921,217 for Evaluation and Management services, based on data in the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 30.3% increase over 2023, when claims for these services amounted to $12,216,959.

Medicaid is a public insurance program managed by the states and funded jointly by federal and state governments. The program serves low-income people and families, seniors, children, and those with disabilities, making it a major component of the U.S. health care landscape.

Because Medicaid payments are taxpayer funded, fluctuations in local billing levels provide insights into how health care resources are distributed in the community.

The Evaluation and Management category comprises Medicaid-billed services based on the care provided, identified by standard HCPCS and CPT code groupings. For this analysis, each billing code was assigned to one service category using designated code prefixes and numeric ranges, which enabled related services to be grouped, minimized double counting, and maintained time-based ranking accuracy.

Multiple Medicaid service categories saw spending growth, but Evaluation and Management ranked third in Walnut Creek for Medicaid payments in 2024.

Statewide in California, Evaluation and Management ranked second by total Medicaid payments for the year.

Over five years ending in 2024, Medicaid payments connected to the Evaluation and Management heading in Walnut Creek grew by $10,737,701, or 207.2%. Some periods saw accelerated growth, with significant annual increases in both 2021 and 2022.

Although Evaluation and Management spending was distributed across Walnut Creek, most payments went to just a few ZIP codes. In 2024, ZIP code 94597 saw $6,592,259 in payments, 94598 accounted for $5,048,757, and 94596 totaled $4,247,092. Altogether, the top 3 ZIP codes represented 99.8% of Medicaid payments in this category for the city.

Within Evaluation and Management, payment totals were highly concentrated among a select group of billing codes.

For additional context, while Evaluation and Management payments in Walnut Creek increased 30.3% from 2023 to 2024, Medicaid payments across all categories rose 62.6% in the same period.

According to the Centers for Medicare & Medicaid Services, aggregate federal and state Medicaid expenditures reached an estimated $871.7 billion in fiscal year 2023, roughly 18% of total national health spending, marking a steep rise from approximately $613.5 billion in 2019, before the COVID-19 pandemic.

This growth—about 40% over several years—has largely been attributed to heightened enrollment and utilization during and following the pandemic.

Federal budget legislation enacted under the Trump administration includes major plans to decrease federal Medicaid outlays and alter the program’s structure. The “One Big Beautiful Bill Act,” signed in 2025, is set to reduce federal Medicaid spending by over $1 trillion in the next 10 years, adds measures such as work requirements and greater cost-sharing, and may cut both coverage and funding for certain recipients. The anticipated result is more state-level financial responsibility and moderated federal Medicaid funding growth, even as the program covers tens of millions in the U.S.

Note: HCPCS codes are listed to provide context within the group. Totals and ranked standings in this article reflect standardized service groupings, not individual billing codes.

Data in this article draws from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data is available here.