Fallston’s Medicaid Evaluation and Management payments total $129,316 in 2024

In 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show that Medicaid providers in Fallston billed $129,316 for services grouped under the Evaluation and Management category. This represented a 4.2% rise compared with 2023, when providers billed $124,116 for the same services.

Medicaid operates as a public health insurance program funded jointly by state and federal governments and administered by states. The program serves low-income people and families, seniors, children and individuals with disabilities, making it a significant component of the U.S. health care system.

Because Medicaid payments are funded by taxpayers, shifts in local billing patterns highlight how public health resources are used throughout a community.

The “Evaluation and Management” category includes a collection of Medicaid-billed services, grouped based on the care type as classified by standardized HCPCS and CPT code structures. This analysis attached each billing code to one service category through the use of stable code prefixes and number segments to analyze related care delivery and maintain accurate rankings and prevent double-counting over time.

Although Medicaid spending climbed across various service groups, Evaluation and Management stood out as the top category in Fallston by overall Medicaid payments in 2024.

Statewide, the Evaluation and Management category was ranked second in Maryland for total Medicaid payments that year.

Over the five years preceding 2024, Medicaid payments to the Evaluation and Management category in Fallston increased by $263,447, representing a 67.1% gain. Growth in spending strengthened during select periods, most notably during 2020 and 2023, which saw substantial year-over-year increases.

While care delivered in the Evaluation and Management group was billed across the entire city, a concentrate exists within a small number of ZIP codes. In 2024, ZIP code 21047 recorded the highest Medicaid payments for Evaluation and Management, totaling $129,315. Overall, these top 1 ZIP codes made up 100% of Fallston’s Medicaid payments for the category during that year.

Within Evaluation and Management, Medicaid reimbursements were further concentrated within a small set of individual billing codes.

To contextualize, between 2024 and 2023, Medicaid spending for Evaluation and Management climbed by 4.2% in Fallston, while total Medicaid claims across all categories showed a 14.6% shift during the same timeframe.

According to the Centers for Medicare & Medicaid Services, total Medicaid expenditures from the federal and state levels reached about $871.7 billion in fiscal 2023, making up roughly 18% of all national health spending, up sharply from about $613.5 billion in 2019, before the COVID-19 pandemic emerged.

This marks an approximate 40% growth over several years, influenced mostly by broader program enrollment and increased health service use associated with and following the pandemic period.

Recent federal budget actions during the Trump administration introduced major proposals to lower federal Medicaid outlays and restructure the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid spending by more than $1 trillion in the next decade, instituting policies such as work requirements and more cost-sharing that could mean smaller coverage and reduced funding for certain recipients. These changes are projected to move increased costs to the states and restrict federal Medicaid growth, while the program continues to serve tens of millions of people.

Note: HCPCS codes are provided as reference within the category. Category aggregates and rankings used in this report are based on consistent service groupings, not on individual billing codes.

This article references data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original source information is available here.