In 2024, Medicaid providers in Abingdon billed $1,186,437 for Evaluation and Management services, based on information from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects a 4.1% uptick from 2023, when claims for the same service category totaled $1,139,517.
Medicaid operates as a public health insurance program managed by the states and financed in partnership by federal and state governments. Its coverage extends to low-income individuals and families, seniors, children, and people with disabilities, positioning it as a cornerstone of the U.S. healthcare system.
Since Medicaid funds are provided by taxpayers, patterns in local billing illustrate how public healthcare finances are distributed within communities.
The Evaluation and Management category includes a range of Medicaid-billed services, determined by the type of care based on specified HCPCS and CPT code sets. For this data analysis, each code was assigned to a unique service category using standardized code prefixes and numeric intervals, enabling an accurate overview of group spending, preventing overlap, and maintaining consistency in tracking over time.
While Medicaid spending increased across several service categories, Evaluation and Management represented the second-highest category for total Medicaid payments in Abingdon in 2024.
Statewide in Maryland, the Evaluation and Management category also ranked second by total Medicaid payments that year.
Between 2019 and 2024, Medicaid payments for the Evaluation and Management category in Abingdon climbed by $459,538, representing a 63.2% rise. Growth in spending was uneven, with significant increases seen year-over-year in 2020 and 2023.
Though Evaluation and Management services were delivered throughout Abingdon, Medicaid payments were focused in a small number of ZIP codes. In 2024, ZIP code 21009 accounted for $1,186,437, making up 100% of payments linked to Evaluation and Management for the city during the year.
A concentrated set of billing codes received the bulk of Medicaid payments in the Evaluation and Management category.
In comparison, Medicaid payments for the Evaluation and Management category in Abingdon grew by 4.1% from 2023 to 2024, outpacing the 2.8% overall change among all Medicaid claim categories in the city during that period.
Data from the Centers for Medicare & Medicaid Services show that combined federal and state Medicaid expenditures reached about $871.7 billion in fiscal 2023. This sum accounted for about 18% of total national health costs, a notable increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This increase reflects growth of approximately 40% over several years, primarily attributed to expanded enrollment and greater usage in and after the pandemic.
Recent federal budget measures enacted during the Trump administration proposed significant cuts to federal Medicaid spending and plans to restructure the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is projected to reduce federal Medicaid expenditures by more than $1 trillion over 10 years. It also introduces new policies such as work requirements and increased cost-sharing, which could lower coverage and funding for specific Medicaid beneficiaries. These adjustments are expected to shift more financial responsibility to states and moderate the pace of federal Medicaid funding growth, while the program continues to serve tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $726,898 | 332% |
| 2021 | $780,595 | 7.4% |
| 2022 | $920,713 | 18% |
| 2023 | $1,139,516 | 23.8% |
| 2024 | $1,186,437 | 4.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $2,686,660 | 52.7% |
| 2 | Evaluation and Management | $1,186,437 | 23.3% |
| 3 | Alcohol and Drug Abuse Treatment | $652,776 | 12.8% |
| 4 | Dental Services | $224,038 | 4.4% |
| 5 | National Codes Established for State Medicaid Agencies | $209,696 | 4.1% |
| 6 | Pathology and Laboratory Procedures | $90,680 | 1.8% |
| 7 | Procedures / Professional Services | $49,275 | 1% |
| 8 | Surgery | $1,776 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $617,600 | 134 |
| 99213 | Office o/p est low 20 min | $294,965 | 80 |
| 99215 | Office o/p est hi 40 min | $214,611 | 12 |
| 99204 | Office o/p new mod 45 min | $44,856 | 21 |
| 99439 | Chrnc care mgmt staf ea addl | $13,763 | 13 |
| 99223 | 1st hosp ip/obs high 75 | $416 | 1 |
| 99490 | Chrnc care mgmt staff 1st 20 | $222 | 13 |
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.
