In 2024, Medicaid providers in Mariposa received $1,512,049 for services in the Evaluation and Management category, figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This represented an 82.3% rise over 2023, when claims for these services totaled $829,332.
Medicaid is a public health insurance initiative administered by the states and financed through federal and state funding. The program serves low-income individuals and families, seniors, children, and those with disabilities, making it among the largest sections of the nation’s health care system.
Since Medicaid is taxpayer-funded, shifts in local billing mirror how public health care resources are distributed in a community.
The “Evaluation and Management” classification covers a set of Medicaid services as defined by care type, utilizing standardized HCPCS and CPT code groups. This report assigned each billing code to a single service category based on consistent coding prefixes and number ranges, grouping related services together to allow for precise analysis and to maintain accurate year-over-year comparisons.
Though Medicaid spending increased across various service lines, Evaluation and Management held the No. 2 spot for total Medicaid payments in Mariposa for 2024.
Across California, Evaluation and Management also secured the second-highest ranking by Medicaid payments in 2024.
Between 2019 and 2024, Mariposa’s Medicaid payments for Evaluation and Management services climbed by $1,396,604 — a jump of 1209.8%. Growth in spending moved notably higher in certain intervals, with sizable year-over-year gains in 2023 and 2021.
Spending on Evaluation and Management services was seen throughout the city, but payments were concentrated within a few ZIP codes. In 2024, ZIP code 95338 accounted for $1,512,048 in such Medicaid payments, representing 100% of Mariposa’s total for the category that year.
Within the same service category, Medicaid disbursements focused heavily on a select group of billing codes.
For context, Medicaid payments connected to Evaluation and Management services in Mariposa grew 82.3% from 2023 to 2024, compared with a 34.5% increase across all Medicaid claim types in the city during that span.
Centers for Medicare & Medicaid Services data shows federal and state Medicaid spending combined reached about $871.7 billion in fiscal year 2023, making up roughly 18% of all U.S. health expenditures—an increase from approximately $613.5 billion in 2019, prior to the COVID-19 pandemic.
This rise equates to growth of about 40% in just a few years, mainly due to greater enrollment and increased service use during and after the pandemic.
Federal budget laws passed during the Trump administration have featured major suggestions to decrease federal Medicaid allocations and shift the program structure. The “One Big Beautiful Bill Act,” enacted in 2025, is forecast to reduce federal Medicaid spending by more than $1 trillion over a decade and implement requirements such as work mandates and higher cost-sharing, potentially trimming coverage and funding for some groups. These shifts are projected to move financial responsibility further to states and moderate future federal Medicaid funding growth, while the program continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $115,444 | -19.4% |
| 2021 | $229,393 | 98.7% |
| 2022 | $260,512 | 13.6% |
| 2023 | $829,331 | 218.3% |
| 2024 | $1,512,048 | 82.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $19,160,861 | 82.7% |
| 2 | Evaluation and Management | $1,512,048 | 6.5% |
| 3 | Medicine Services and Procedures | $1,186,223 | 5.1% |
| 4 | Alcohol and Drug Abuse Treatment | $807,105 | 3.5% |
| 5 | Procedures / Professional Services | $296,369 | 1.3% |
| 6 | Ambulance and Other Transport Services and Supplies | $84,223 | 0.4% |
| 7 | Pathology and Laboratory Procedures | $59,065 | 0.3% |
| 8 | Dental Services | $45,293 | 0.2% |
| 9 | Temporary Codes | $2,683 | <0.1% |
| 10 | Drugs Administered Other than Oral Method | $1,067 | <0.1% |
| 11 | Radiology Procedures | $415 | <0.1% |
| 12 | Anesthesia | $248 | <0.1% |
| 13 | Surgery | $19 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $474,288 | 197 |
| 99214 | Office o/p est mod 30 min | $328,531 | 95 |
| 99308 | Sbsq nf care low mdm 20 | $199,954 | 327 |
| 99281 | Emr dpt vst mayx req phy/qhp | $132,099 | 52 |
| 99309 | Sbsq nf care moderate mdm 30 | $61,915 | 124 |
| 99205 | Office o/p new hi 60 min | $51,752 | 2 |
| 99284 | Emergency dept visit mod mdm | $51,284 | 37 |
| 99347 | Home/res vst est sf mdm 20 | $35,459 | 67 |
| 99307 | Sbsq nf care sf mdm 10 | $32,863 | 218 |
| 99283 | Emergency dept visit low mdm | $29,247 | 69 |
| 99310 | Sbsq nf care high mdm 45 | $28,640 | 65 |
| 99203 | Office o/p new low 30 min | $18,496 | 26 |
| 99306 | 1st nf care high mdm 50 | $15,870 | 19 |
| 99305 | 1st nf care moderate mdm 35 | $9,711 | 38 |
| 99395 | Prev visit est age 18-39 | $9,366 | 6 |
| 99304 | 1st nf care sf/low mdm 25 | $6,572 | 24 |
| 99291 | Critical care first hour | $5,135 | 2 |
| 99285 | Emergency dept visit hi mdm | $4,226 | 4 |
| 99396 | Prev visit est age 40-64 | $4,139 | 4 |
| 99394 | Prev visit est age 12-17 | $2,872 | 3 |
Note: HCPCS codes are provided for context. Totals and rankings referenced are based on standardized service categories instead of individual codes.
Information referenced in this article was sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data is available here.