Newton sees 31.5% rise in Medicaid Evaluation and Management payments in 2024

In 2024, Medicaid providers in Newton submitted $690,207 in claims for services under the Evaluation and Management category, based on figures in the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 31.5% rise from 2023, when claims for these services totaled $524,790.

Medicaid is a government health insurance initiative run by states with joint federal and state funding, providing coverage to low-income individuals, families, seniors, children, and those with disabilities. These groups make Medicaid a leading element of the U.S. health care landscape. For more on program funding, see this explainer.

Because Medicaid spending relies on taxpayer funding, trends in local billing offer a window into how community health care dollars are spent.

The “Evaluation and Management” group includes Medicaid-billed services characterized by their type of medical care, organized using standard HCPCS and CPT code prefixes and numeric ranges. Analysts assigned each code to a single category, supporting analysis of related services without duplication and enabling consistent year-to-year comparisons.

In Newton, spending for the Evaluation and Management category ranked third among Medicaid service categories in 2024 as overall Medicaid expenditures grew across several groups.

Statewide in North Carolina, Evaluation and Management placed second overall for Medicaid payments in 2024.

Looking at the five-year span heading into 2024, Newton’s Medicaid payments for Evaluation and Management grew by $494,276, or 252.3%. Certain years, specifically 2021 and 2022, saw marked year-over-year spikes in spending for this category.

While the cost of Evaluation and Management care was distributed throughout Newton, payment activity concentrated heavily in specific ZIP codes. In 2024, code 28658 alone accounted for $690,206—capturing 100% of these Medicaid payments for the city during that time.

Much of the city’s Evaluation and Management payments were linked to just a small set of individual billing codes.

For additional context, the 31.5% uptick for Evaluation and Management services in Newton between 2024 and 2023 outpaced the citywide growth rate of 8.4% across all Medicaid claim categories in the same timeframe.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023, making up about 18% of total national health outlays—a surge from $613.5 billion in 2019, before the COVID-19 pandemic.

This amounts to about 40% growth over just several years, mainly fueled by expanded enrollment and increased medical usage brought on during and after the pandemic.

Recent federal budget laws from the Trump administration have advanced notable changes that would reduce federal Medicaid support and reshape the program. For example, the “One Big Beautiful Bill Act,” which became law in 2025, is projected to lower federal Medicaid outlays by over $1 trillion in the next 10 years. It also brings new policies like work requirements and higher beneficiary cost-sharing, measures expected to lessen some coverage and support and place more responsibility on states, despite Medicaid’s ongoing role for tens of millions of Americans.

Note: HCPCS codes are shown for clarity within the grouping. Totals and rankings reflect standardized service clusters, not individual billing codes.

Article data is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Source materials available here.