In 2024, Medicaid providers in Midvale billed a total of $307,642 for services within the Evaluation and Management category, according to figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The amount rose 98.9% compared with 2023, when providers submitted $154,696 in claims for these services.
Medicaid is a government health insurance program managed by states and financed by both federal and state governments. It insures low-income individuals and families, seniors, children, and people with disabilities, making it one of the largest elements of the U.S. health care infrastructure.
Because Medicaid funding is sourced from taxpayers, shifts in local billing patterns reveal how community health dollars are spent.
The Evaluation and Management category includes Medicaid-billed services grouped by the kind of care delivered, following standardized HCPCS and CPT code definitions. For this report, each billing code was placed in a single service grouping using specific code prefixes and ranges. This methodology grouped related services, eliminated double counting, and kept rankings consistent over time.
Although various Medicaid service categories saw higher spending, Evaluation and Management was the sixth highest in Midvale by total Medicaid payments in 2024.
Statewide in Utah, Evaluation and Management was third in total Medicaid payments throughout 2024.
During the five years before 2024, Medicaid payments linked to Evaluation and Management in Midvale increased by $51,801, or 20.2%. Spending growth spiked during selected periods, especially in 2021 and 2020, where significant annual increases were documented.
While Evaluation and Management spending spanned the city, payment totals were heavily concentrated in a small number of ZIP codes. In 2024, ZIP code 84047 alone recorded $307,642 in Medicaid payments for this category. The top 1 ZIP code accounted for 100% of the category’s Medicaid payments within Midvale that year.
Within this category, Medicaid dollars were focused on a narrow set of primary billing codes.
By comparison, Evaluation and Management Medicaid payments in Midvale climbed 98.9% between 2024 and 2023, while all Medicaid claim categories citywide increased by 26.1% in that time frame.
The Centers for Medicare & Medicaid Services reports that federal and state Medicaid spending together totaled approximately $871.7 billion in fiscal year 2023, representing about 18% of national health expenditures—a substantial rise from $613.5 billion in 2019, preceding the COVID-19 pandemic.
This marks nearly a 40% increase in just a few years, driven in large part by broader enrollment and greater health care use during and after the pandemic.
Recent federal budget laws enacted during the Trump administration have included major proposals to reduce federal Medicaid funding and change the program structure. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is anticipated to reduce federal Medicaid spending by more than $1 trillion over the next 10 years and introduces work requirements and higher cost-sharing that may limit benefits and funding for some recipients. The changes are expected to pass more costs to states and slow federal support, even as Medicaid serves tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $255,840 | 19.4% |
| 2021 | $323,321 | 26.4% |
| 2022 | $338,025 | 4.5% |
| 2023 | $154,695 | -54.2% |
| 2024 | $307,642 | 98.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Medicine Services and Procedures | $1,887,723 | 43.1% |
| 2 | National Codes Established for State Medicaid Agencies | $569,756 | 13% |
| 3 | Orthotic Procedures and services | $486,038 | 11.1% |
| 4 | Drugs Administered Other than Oral Method | $485,140 | 11.1% |
| 5 | Alcohol and Drug Abuse Treatment | $309,286 | 7.1% |
| 6 | Evaluation and Management | $307,642 | 7% |
| 7 | Durable Medical Equipment | $256,111 | 5.9% |
| 8 | Anesthesia | $34,147 | 0.8% |
| 9 | Medical And Surgical Supplies | $21,152 | 0.5% |
| 10 | Vision Services | $11,576 | 0.3% |
| 11 | Radiology Procedures | $3,212 | 0.1% |
| 12 | Pathology and Laboratory Procedures | $1,869 | <0.1% |
| 13 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $1,639 | <0.1% |
| 14 | Surgery | $603 | <0.1% |
| 15 | Dental Services | $195 | <0.1% |
| 16 | Procedures / Professional Services | $18 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99345 | Home/res vst new high mdm 75 | $128,987 | 6 |
| 99214 | Office o/p est mod 30 min | $69,016 | 24 |
| 99213 | Office o/p est low 20 min | $45,759 | 26 |
| 99350 | Home/res vst est high mdm 60 | $40,220 | 5 |
| 99391 | Per pm reeval est pat infant | $10,281 | 12 |
| 99392 | Prev visit est age 1-4 | $6,923 | 12 |
| 99204 | Office o/p new mod 45 min | $2,883 | 3 |
| 99393 | Prev visit est age 5-11 | $2,620 | 5 |
| 99394 | Prev visit est age 12-17 | $668 | 1 |
| 99188 | App topical fluoride varnish | $230 | 7 |
| 99000 | Specimen handling office-lab | $48 | 12 |
| 99173 | Visual acuity screen | $0 | 2 |
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.
