Fillmore Medicaid Evaluation and Management payments grow to $32,185 in 2024

In 2024, Medicaid providers in Fillmore billed $32,185 for Evaluation and Management services, as reported by data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount is a 220.8% rise from 2023, when providers claimed $10,034 for the same services.

Medicaid is administered by states and funded by both federal and state governments. The program covers low-income people, seniors, children, and individuals with disabilities, and is one of the most significant components of the U.S. health care system.

As Medicaid relies on taxpayer funding, fluctuations in local billing show how public health care resources are distributed across communities.

The Evaluation and Management category comprises a set of services Medicaid providers bill for, classified by the care delivered and based on standardized HCPCS and CPT code groupings. For this report, each billing code was assigned solely to a corresponding service category by code prefix and numerical range to group similar services together, avoid duplications, and maintain consistency in category rankings over time.

Although several Medicaid service categories saw spending increases, Evaluation and Management led all other categories in Fillmore for total payments in 2024.

Statewide in Utah, Evaluation and Management ranked third in Medicaid payment totals that year.

From 2019 through 2024, Medicaid payments for Evaluation and Management services in Fillmore rose by $20,742, or 181.3%. Growth was especially strong in certain years, with notable jumps in both 2021 and 2022.

Spending on Evaluation and Management was distributed citywide but remained focused within select ZIP codes. In 2024, the largest Medicaid payments for Evaluation and Management were in ZIP code 84631, accounting for $32,184. In total, this ZIP code represented 100% of all spending in this category in Fillmore that year.

Within Evaluation and Management, most spending centered on just a few billing codes.

Between 2024 and 2023, Evaluation and Management Medicaid payments in Fillmore climbed 220.8%, while all Medicaid claim categories combined increased by 173% during the same period.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenses totaled about $871.7 billion in fiscal year 2023, which was roughly 18% of all national health spending. This is up significantly from around $613.5 billion in 2019, prior to the COVID-19 pandemic.

This increase reflects about a 40% climb over several years, largely due to expanded enrollment and increased utilization during and immediately after the pandemic.

Recent federal budget measures under the Trump administration have put forth several proposals designed to reduce federal Medicaid contributions and restructure the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next 10 years. It also introduces requirements such as work mandates and greater cost-sharing, which could diminish coverage and funds for certain participants, and is expected to result in higher state costs and slowed federal spending growth even as Medicaid continues to serve millions nationwide.

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.