Anaheim Medicaid providers collect $37,392,965 for Evaluation and Management services in 2024

In 2024, Medicaid providers in Anaheim collected $37,392,965 in payments for services under the Evaluation and Management classification, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount, which marked a 96.7% rise from 2023, when providers submitted $19,006,470 in claims for the same category, underscores significant growth in this area.

Medicaid, which is administered by individual states and jointly funded by the federal and state governments, provides coverage for low-income individuals and families, seniors, children, and people with disabilities, making it one of the most significant components of the U.S. health care framework.

Because Medicaid is publicly funded, shifting billing trends reflect how health care dollars sourced from taxpayers are spent within the community.

The “Evaluation and Management” group includes Medicaid-billed services categorized by the type of care delivered, based on standard HCPCS and CPT code groupings. Each code in this examination was mapped to a single service group using specific code prefixes and number ranges, enabling analysis of related services together while preventing duplicate counts and maintaining accurate yearly comparisons.

Though Medicaid expenses grew across several service types, Evaluation and Management was the leading category for Medicaid payments in Anaheim in 2024.

Statewide in California, Evaluation and Management was the second-largest category for total Medicaid payments in 2024.

From 2019 through 2024, Anaheim’s Medicaid payments related to Evaluation and Management services rose by $27,052,035, representing an increase of 261.6%. The most rapid increases were noted in 2021 and 2023 as year-to-year growth accelerated at points during this period.

The majority of Evaluation and Management payments were tied to a few ZIP codes throughout Anaheim. In 2024, ZIP code 92806 led with $13,243,740, followed by 92801 at $9,199,501, and 92807 at $6,252,306. Combined, these top 3 ZIP codes represented 76.7% of all Medicaid Evaluation and Management payments in the city for 2024.

Within the Evaluation and Management group, a small group of individual billing codes composed most of the Medicaid payments.

For context, Anaheim’s Medicaid payments related to Evaluation and Management services climbed 96.7% between 2023 and 2024, while billings across all Medicaid claim categories in Anaheim grew by 31% during the same timeframe.

Data from the Centers for Medicare & Medicaid Services shows that combined federal and state Medicaid expenditures totaled about $871.7 billion in fiscal 2023, making up roughly 18% of the nation’s total health spending. This is a sharp increase from about $613.5 billion in 2019, prior to the COVID-19 pandemic.

This jump represents an approximate 40% expansion in just a few years, attributed mostly to increased enrollment and stronger utilization in the pandemic and post-pandemic period.

Federal budget initiatives during the Trump administration have included moves to shrink federal Medicaid funding and modify the program’s structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to slash over $1 trillion in federal Medicaid outlays across a decade while introducing requirements like mandatory work and greater cost-sharing, potentially reducing coverage and public funding for certain beneficiaries. These policy changes may shift additional costs to the states and curtail continued federal expansion, even as millions remain enrolled.

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.