Old Saybrook Medicaid Evaluation and Management payments reach $195,013 in 2024

In 2024, Medicaid providers in Old Saybrook submitted $195,013 in claims for services under the Evaluation and Management category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total reflects a 0.8% rise compared with 2023, when $193,414 was billed for these services.

Medicaid is a joint federal-state public health insurance program funded by both federal and state governments. It serves low-income individuals and families, seniors, children and people with disabilities, making it a key component of the U.S. health care system.

Because Medicaid payments are supported by taxpayers, shifts in local billing patterns provide insight into how public health care resources are allocated within a community.

The “Evaluation and Management” category comprises a set of Medicaid-billed services defined by the care type delivered, based on standard HCPCS and CPT code groupings. For this analysis, each billing code was placed into a single service category according to code prefixes and numeric ranges, which helped group similar services, avoid duplicate counting, and maintain accurate rankings across years.

While spending increased in several Medicaid claim categories, Evaluation and Management was the second largest by total Medicaid payments in Old Saybrook in 2024.

Across Connecticut, Evaluation and Management ranked first in total Medicaid payments for 2024.

Over the five years ending in 2024, Medicaid payments for Evaluation and Management services in Old Saybrook grew by $48,722, equating to a 33.3% increase. Periods of faster growth were observed, especially with notable year-over-year gains in 2023 and 2022.

Though these services were available throughout Old Saybrook, most of the related Medicaid payments were concentrated in a few ZIP codes. In 2024, ZIP code 06475 accounted for the entire $195,013 billed in the Evaluation and Management category, making up 100% of citywide Medicaid payments for these services that year.

Within Evaluation and Management, payments were also focused among a select number of billing codes.

For context, Evaluation and Management Medicaid payments in Old Saybrook rose 0.8% between 2024 and 2023, whereas citywide Medicaid claims across all categories changed by 14.1% during that period.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending reached approximately $871.7 billion in fiscal year 2023, making up about 18% of national health expenditures—a sharp increase from $613.5 billion in 2019, before the pandemic.

This roughly 40% growth in a few years was driven primarily by expanded enrollment and increased utilization during and after the pandemic.

Recent federal budget measures during the Trump administration have proposed major reductions to federal Medicaid funding and changes to the program structure. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is projected to cut federal Medicaid spending by over $1 trillion over 10 years, adding policies such as work requirements and heightened cost-sharing, potentially affecting coverage and funding for certain beneficiaries. These adjustments are expected to place greater fiscal responsibility on states and temper federal Medicaid funding growth, while the program continues to serve 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.