Medicaid providers in Price billed $1,595,183 for services in the Evaluation and Management category in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This constituted a 7.9% rise from 2023, when $1,478,210 was recorded for the same type of service.
Medicaid is a state-administered, public health insurance program, funded by federal and state governments together. It serves low-income people and families, older adults, children, and individuals with disabilities, functioning as a significant part of the U.S. health care system.
Because taxpayer funds support Medicaid, trends in local billing illustrate how public health resources are used in a particular area.
The “Evaluation and Management” category includes a group of Medicaid-billed services distinguished by care types, which are assigned by standardized HCPCS and CPT code groupings. Unique billing codes were organized under a single service category for this analysis, using set code prefixes and numeric divisions. This method allows for consistent reviews while eliminating overlap and maintaining consistent rankings over time.
The Evaluation and Management category received the largest amount of Medicaid payments in Price in 2024, even as overall spending grew across multiple categories.
Statewide, Utah saw Evaluation and Management as the third-largest Medicaid payment category in 2024.
Medicaid payments in Price tied to Evaluation and Management climbed by $448,254—or 39.1%—throughout the five years up to 2024. Spending saw sharper increases in specific periods, including strong year-on-year gains in 2020 and 2021.
While these services were delivered throughout the city, the bulk of Medicaid payments was directed to only a few ZIP codes. The leading ZIP code in 2024 was 84501, accounting for $1,595,183—or 100%—of all Evaluation and Management Medicaid payments in Price.
Payments in this category concentrated among a small set of individual billing codes.
Comparatively, Evaluation and Management Medicaid payments in Price grew by 7.9% from 2023 to 2024, while total Medicaid payment categories citywide rose by 16% for the period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid spending totaled about $871.7 billion in fiscal year 2023, making up around 18% of all national health spending. This reflects a notable jump from $613.5 billion in 2019, before the COVID-19 pandemic.
This expansion marks roughly 40% growth in a few years, mainly from greater enrollment and expanded use during and after the pandemic period.
Recent federal budget initiatives from the Trump administration have featured notable Medicaid funding cuts and restructuring ideas. For example, the “One Big Beautiful Bill Act,” approved in 2025, will reduce federal Medicaid support by more than $1 trillion over 10 years and brings changes such as work requirements and heightened cost-sharing, which could affect funding and coverage for certain recipients. These revisions are projected to place more financial responsibility on the states and slow the pace of federal Medicaid growth while the program continues to cover tens of millions across the country.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,146,929 | 28.1% |
| 2021 | $1,454,217 | 26.8% |
| 2022 | $1,504,918 | 3.5% |
| 2023 | $1,478,210 | -1.8% |
| 2024 | $1,595,183 | 7.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $1,595,183 | 35.6% |
| 2 | Medicine Services and Procedures | $1,039,185 | 23.2% |
| 3 | Alcohol and Drug Abuse Treatment | $975,231 | 21.8% |
| 4 | National Codes Established for State Medicaid Agencies | $455,331 | 10.2% |
| 5 | Ambulance and Other Transport Services and Supplies | $230,151 | 5.1% |
| 6 | Radiology Procedures | $52,023 | 1.2% |
| 7 | Dental Services | $51,493 | 1.2% |
| 8 | Pathology and Laboratory Procedures | $47,030 | 1.1% |
| 9 | Durable Medical Equipment | $12,815 | 0.3% |
| 10 | Surgery | $5,383 | 0.1% |
| 11 | Vision Services | $4,342 | 0.1% |
| 12 | Anesthesia | $4,005 | 0.1% |
| 13 | Procedures / Professional Services | $3,195 | 0.1% |
| 14 | Drugs Administered Other than Oral Method | $621 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $438,641 | 112 |
| 99284 | Emergency dept visit mod mdm | $386,445 | 58 |
| 99214 | Office o/p est mod 30 min | $343,407 | 58 |
| 99285 | Emergency dept visit hi mdm | $143,258 | 14 |
| 99283 | Emergency dept visit low mdm | $134,263 | 44 |
| 99211 | Off/op est may x req phy/qhp | $70,815 | 4 |
| 99222 | 1st hosp ip/obs moderate 55 | $19,254 | 10 |
| 99203 | Office o/p new low 30 min | $15,451 | 11 |
| 99392 | Prev visit est age 1-4 | $10,724 | 7 |
| 99391 | Per pm reeval est pat infant | $10,520 | 9 |
| 99204 | Office o/p new mod 45 min | $5,215 | 3 |
| 99215 | Office o/p est hi 40 min | $5,078 | 2 |
| 99212 | Office o/p est sf 10 min | $4,187 | 7 |
| 99238 | Hosp ip/obs dschrg mgmt 30/< | $3,389 | 5 |
| 99291 | Critical care first hour | $2,723 | 1 |
| 99495 | Transj care mgmt mod f2f 14d | $1,572 | 1 |
| 99406 | Behav chng smoking 3-10 min | $235 | 4 |
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.
