Brea records $7.1 million in Medicaid payments for Evaluation and Management services in 2024

In 2024, Medicaid providers in Brea billed $7,147,808 for Evaluation and Management services, based on information from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure is up 4% from the $6,876,004 in claims submitted by providers for the same service group in 2023.

Medicaid, a public health insurance program, is managed by states and funded through a partnership of federal and state governments. It offers coverage to low-income families and individuals, seniors, children and certain people with disabilities, making it a significant component of the U.S. health care infrastructure.

Because taxpayer funding supports Medicaid, fluctuations in local billing draw attention to how public health resources are spent within a community.

The Evaluation and Management category encompasses Medicaid billing codes that categorize services based on the care level, using standardized HCPCS and CPT codes. For analysis, each code was placed into a specific service group using consistent prefixes and ranges to form categorical rankings without duplication, ensuring comparability over time.

While Medicaid expenditures increased across several categories, Evaluation and Management services ranked as Brea’s highest for total Medicaid payments in 2024.

Statewide, Evaluation and Management services ranked as the second largest Medicaid payment category in California for 2024.

Across the five years before 2024, Brea’s Medicaid payments for Evaluation and Management saw an increase of $2,746,876, amounting to a 62.4% rise. Growth intervals varied, with marked year-over-year gains seen in 2021 and 2023.

Although spending was distributed throughout Brea, the majority of payments came from a limited number of ZIP codes. The highest concentration of Medicaid payments tied to Evaluation and Management, $7,147,807 in 2024, was tied to ZIP code 92821, which made up all (100%) Medicaid spending for Evaluation and Management in Brea that year.

Within this category, payments were further consolidated among a small set of billing codes.

For context, while Brea’s Medicaid payments for Evaluation and Management increased 4% from 2023 to 2024, overall Medicaid claim categories in the city saw a slightly larger 4.1% change over that period.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid outlays reached approximately $871.7 billion in fiscal year 2023, accounting for about 18% of the nation’s health spending—an increase from roughly $613.5 billion in 2019, the period ahead of the COVID-19 pandemic.

This nearly 40% growth over several years was largely fueled by increased enrollment and health care use during and following the pandemic.

Major federal budget initiatives during the Trump administration have featured proposals for notable reductions to federal Medicaid support and program changes. The “One Big Beautiful Bill Act,” which became law in 2025, is projected to reduce federal Medicaid funding by more than $1 trillion over 10 years, instituting work requirements and enhanced cost-sharing. As a result, these changes may limit funding and coverage for some Medicaid beneficiaries and are expected to shift additional financial responsibility to states even as beneficiary numbers remain high.

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.