Medicaid pays $509,070 for Evaluation and Management services in Essex during 2024

In 2024, Medicaid providers in Essex billed a total of $509,070 for services under the Evaluation and Management category, the U.S. Department of Health and Human Services Medicaid Provider Spending database reported. That figure marks a 3.7% increase from 2023, when claims for the same services totaled $491,084.

Medicaid is a government-run health insurance program funded by both federal and state governments. Covering low-income families, seniors, children, and people with disabilities, it stands as one of the largest components of the U.S. health care landscape.

As Medicaid uses taxpayer funds, fluctuations in community-level billing point to shifts in the allocation of public health care spending locally.

The Evaluation and Management designation represents a suite of Medicaid-billed services defined by the nature of care provided, using established HCPCS and CPT code groupings. For this analysis, each billing code was exclusively assigned to one service group based on code structure, ensuring related services were grouped together for accurate trend assessment and avoiding double counting within category rankings.

Evaluation and Management topped all service categories by total Medicaid spending in Essex for 2024 amid broader increases in several medical service groups.

Evaluation and Management also ranked first for Medicaid payments statewide in Connecticut that same year.

Between 2019 and 2024, Essex saw Medicaid payments tied to Evaluation and Management grow by $106,397, equating to a 26.4% rise. Notable year-over-year increases were registered in 2022 and 2023, pushing growth rates higher at specific periods.

Although spending under this category was distributed throughout Essex, the bulk of payments came from a small number of ZIP codes. In 2024, ZIP code 06426 accounted for $509,070—representing 100% of Medicaid payments for Evaluation and Management in Essex that year.

The category’s Medicaid spending was largely concentrated among a select group of procedure/billing codes.

In comparison, the 3.7% increase for Evaluation and Management services in Essex from 2023 to 2024 was below the 4.9% rise seen across all Medicaid claim categories citywide during the same window.

Centers for Medicare & Medicaid Services data show combined federal and state Medicaid expenditure reached roughly $871.7 billion in fiscal year 2023—approximately 18% of total national health costs—rising from $613.5 billion in 2019 before the onset of COVID-19.

This reflects nearly 40% growth across a few years, driven by expanded coverage rolls and increased service use associated with and following the pandemic.

Recent federal budgets signed under the Trump administration proposed steep federal Medicaid cutbacks and redesigns of the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is estimated to slash more than $1 trillion from federal Medicaid spending over 10 years and applies new work requirements, higher cost-sharing and policies which experts project could curtail both coverage and overall funding for some enrollees. Such measures are expected to shift an increasing share of costs to states and curb growth in the federal commitment even as the benefit continues to cover tens of 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.