Medicaid Evaluation and Management payments in Castle Dale climbed 7.3% in 2024

According to the U.S. Department of Health and Human Services Medicaid Provider Spending database, providers in Castle Dale submitted $241,860 in Medicaid claims categorized as Evaluation and Management services in 2024. This represents a 7.3% rise from the previous year’s $225,406 in claims for these services.

Medicaid, a public health insurance program funded jointly by state and federal governments, serves low-income residents, older adults, children, and individuals with disabilities, making it a substantial component of the American health care system.

As Medicaid payments are funded by taxpayers, fluctuations in local billing trends reflect how public health funding is distributed within communities.

The Evaluation and Management category contains Medicaid services structured around standardized HCPCS and CPT coding groupings, each based on the care provided. Billing codes were consistently assigned to service categories by code prefixes and number ranges, allowing for accurate year-over-year assessment and ranking without overlap.

Among multiple service categories that saw Medicaid spending increases, Evaluation and Management held the second-highest rank by total Medicaid payments in Castle Dale in 2024.

Statewide in Utah, Evaluation and Management was ranked third for total Medicaid payments in 2024.

Over the five-year span leading to 2024, Castle Dale’s Medicaid payments for Evaluation and Management services grew by $232,625, or 2518.9%. Periods such as 2021 and 2023 saw the most substantial annual growth rates within that span.

Although Evaluation and Management Medicaid payments were distributed across Castle Dale, the majority occurred in just a few ZIP codes. In 2024, ZIP code 84513 accounted for $241,859 in claims, representing 100% of the city’s Medicaid Evaluation and Management payments.

Payment levels were also concentrated within a narrow selection of individual billing codes in the Evaluation and Management category.

For comparison, Evaluation and Management Medicaid claims in Castle Dale increased 7.3% from 2023 to 2024, compared to a 4.4% increase across all claim categories in the city during the same timeframe.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures amounted to roughly $871.7 billion in fiscal 2023, making up about 18% of total national health spending—up significantly from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This uptick amounts to an approximate 40% increase over several years, mainly from enrollment growth and greater utilization during and after the pandemic period.

Federal budget initiatives from the Trump administration have proposed major reductions to Medicaid’s federal funding and reforms in the structure of the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is slated to reduce federal Medicaid spending by over $1 trillion in the coming decade. It introduces policies such as work mandates and higher cost-sharing, potentially reducing access and funding for certain beneficiaries. These provisions are likely to increase fiscal pressure on states and could slow the expansion of federal Medicaid support, even with the program still supporting tens of millions of Americans.

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.