Riverton Medicaid providers billed $463,661 for services categorized as Evaluation and Management in 2024, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount was a 13.4% rise over 2023, when providers filed $408,963 in claims for the category.
Medicaid is a public health insurance initiative administered by states and financially supported by both the federal and state governments. The program serves low-income individuals, families, seniors, children, and those with disabilities, making it a central component of the U.S. health care system.
Since Medicaid funding is sourced from taxpayers, shifts in local billing amounts provide insight into the distribution of public health care funds within a community.
The “Evaluation and Management” category includes Medicaid-billed services that are organized by type of care delivered and are identified using standard HCPCS and CPT codes. For this report, each code was assigned exclusively to one service group using consistent prefixes and number ranges, which allows related services to be analyzed together, reduces duplicate counting, and maintains accurate comparisons over time.
While Medicaid expenditures rose in multiple service categories, Evaluation and Management was the second-highest by payment total in Riverton for 2024.
Across Utah, Evaluation and Management ranked third statewide among Medicaid payment categories that year.
Between 2019 and 2024, Riverton’s Medicaid payments within the Evaluation and Management category increased by $296,920, a 178.1% jump. Certain periods, such as 2021 and 2022, saw especially notable year-to-year growth.
Although spending for Evaluation and Management services occurred in different parts of Riverton, the highest payment volumes were concentrated within just two ZIP codes. In 2024, ZIP code 84065 accounted for $441,072 and 84096 for $22,588 in Medicaid payments, combining to represent 100% of Evaluation and Management payments in the city during that year.
Most Medicaid payments within the Evaluation and Management group were tied to a small group of specific billing codes.
To compare, Medicaid payments associated with the Evaluation and Management category in Riverton increased by 13.4% from 2023 to 2024, while payments citywide across all Medicaid claim types grew by 7.1% over the same interval.
Centers for Medicare & Medicaid Services data show combined federal and state Medicaid dollars totaled approximately $871.7 billion in fiscal year 2023, representing about 18% of all national health spending, up sharply from roughly $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This jump amounts to a growth of nearly 40% over a few years, driven mostly by increased enrollment and greater use of services during and after the pandemic timeframe.
Federal budget measures enacted under the Trump administration have featured sizable recommendations to trim federal Medicaid funds and reshape the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to cut more than $1 trillion in federal Medicaid outlays over the next decade, introducing policies such as work mandates and higher cost-sharing that may decrease funding and coverage for certain participants. These adjustments will likely increase cost responsibilities for states and moderate the rise of federal Medicaid support as the program maintains service for millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $166,740 | -27.8% |
| 2021 | $340,056 | 103.9% |
| 2022 | $418,026 | 22.9% |
| 2023 | $408,962 | -2.2% |
| 2024 | $463,660 | 13.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $2,107,021 | 68.5% |
| 2 | Evaluation and Management | $463,660 | 15.1% |
| 3 | Alcohol and Drug Abuse Treatment | $365,744 | 11.9% |
| 4 | Dental Services | $58,988 | 1.9% |
| 5 | Pathology and Laboratory Procedures | $38,115 | 1.2% |
| 6 | National Codes Established for State Medicaid Agencies | $24,179 | 0.8% |
| 7 | Surgery | $14,591 | 0.5% |
| 8 | Radiology Procedures | $3,356 | 0.1% |
| 9 | Procedures / Professional Services | $157 | <0.1% |
| 10 | Drugs Administered Other than Oral Method | $28 | <0.1% |
| 11 | Hearing Services | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $132,531 | 89 |
| 99213 | Office o/p est low 20 min | $102,801 | 69 |
| 99223 | 1st hosp ip/obs high 75 | $46,454 | 11 |
| 99233 | Sbsq hosp ip/obs high 50 | $44,015 | 10 |
| 99239 | Hosp ip/obs dschrg mgmt >30 | $23,886 | 11 |
| 99349 | Home/res vst est mod mdm 40 | $22,641 | 11 |
| 99204 | Office o/p new mod 45 min | $14,559 | 11 |
| 99284 | Emergency dept visit mod mdm | $12,541 | 9 |
| 99283 | Emergency dept visit low mdm | $10,881 | 7 |
| 99393 | Prev visit est age 5-11 | $10,516 | 11 |
| 99491 | Chrnc care mgmt phys 1st 30 | $10,211 | 10 |
| 99391 | Per pm reeval est pat infant | $9,908 | 11 |
| 99203 | Office o/p new low 30 min | $5,637 | 6 |
| 99392 | Prev visit est age 1-4 | $5,567 | 11 |
| 99394 | Prev visit est age 12-17 | $3,867 | 5 |
| 99350 | Home/res vst est high mdm 60 | $2,375 | 2 |
| 99238 | Hosp ip/obs dschrg mgmt 30/< | $1,826 | 2 |
| 99418 | Prolng ip/obs e/m ea 15 min | $1,773 | 2 |
| 99345 | Home/res vst new high mdm 75 | $1,573 | 1 |
| 99497 | Advncd care plan 30 min | $83 | 1 |
Note: HCPCS codes are provided for reference within the group. The totals and rankings in this article are calculated based on standardized service groupings and not on the individual codes themselves.
This article’s information originates from the U.S. Department of Health and Human Services Medicaid Provider Spending database. To view the source data, click here.
