East Longmeadow Medicaid providers billed $586,223 for Evaluation and Management services in 2024, according to U.S. Department of Health and Human Services Medicaid Provider Spending data. This figure reflects a 13.7% rise from 2023, when $515,459 in claims were reported for this service category.
Medicaid serves as a public health insurance program jointly funded by federal and state governments, covering individuals and families with low incomes, seniors, children, and those with disabilities. It remains a cornerstone of the U.S. health care system. More on program funding is available from the Commonwealth Fund.
Shifts in Medicaid billing levels reflect how taxpayer-funded health care dollars are distributed locally.
The Evaluation and Management category covers Medicaid-billed services grouped by care type, with defined HCPCS and CPT code groupings. Each code for this analysis was assigned to a specific service group via standardized prefixes and number ranges, supporting consistent comparisons while eliminating duplicate entries.
Multiple Medicaid service areas saw increased spending, with Evaluation and Management ranking third for total payments in East Longmeadow for 2024.
Statewide, this service group was fifth in total Medicaid payments across Massachusetts in 2024.
Looking at the five years before 2024, East Longmeadow Medicaid payments for Evaluation and Management services rose by $426,250—or 266.5%. Accelerated spending growth was seen during certain time frames, particularly in 2021 and 2022.
Payments for services in this category were spread throughout the city but largely concentrated in a handful of ZIP codes. In 2024, ZIP code 01028 accounted for $586,223, making up 100% of Evaluation and Management Medicaid spending in East Longmeadow during the year.
Within the category, a narrow set of billing codes represented the majority of Medicaid payments.
In comparison, the 13.7% spending increase for Evaluation and Management services between 2024 and 2023 outpaced the 5.5% growth reported for all local Medicaid claim categories over that period.
Data from the Centers for Medicare & Medicaid Services show federal and state Medicaid spending reached about $871.7 billion in fiscal year 2023, totaling roughly 18% of U.S. health expenditures—an increase from around $613.5 billion in 2019, prior to the COVID-19 pandemic.
The roughly 40% growth over several years was primarily driven by more enrollees and increased service use connected to the pandemic and its aftermath.
Federal budget measures enacted during the Trump administration brought major proposals to reduce federal Medicaid funding and adjust how the program is structured. The “One Big Beautiful Bill Act,” made law in 2025, is on track to cut federal Medicaid spending by more than $1 trillion over the coming decade, instituting work requirements and cost-sharing policies likely to reduce both coverage and funding levels for some participants. These policies are forecasted to shift more financial responsibility onto states and limit federal Medicaid spending increases, even as the program continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $159,972 | -19.1% |
| 2021 | $268,784 | 68% |
| 2022 | $415,216 | 54.5% |
| 2023 | $515,459 | 24.1% |
| 2024 | $586,223 | 13.7% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $11,113,051 | 83% |
| 2 | Medicine Services and Procedures | $830,921 | 6.2% |
| 3 | Evaluation and Management | $586,223 | 4.4% |
| 4 | Dental Services | $488,348 | 3.6% |
| 5 | Procedures / Professional Services | $178,380 | 1.3% |
| 6 | Ambulance and Other Transport Services and Supplies | $145,397 | 1.1% |
| 7 | Alcohol and Drug Abuse Treatment | $25,135 | 0.2% |
| 8 | Pathology and Laboratory Procedures | $15,029 | 0.1% |
| 9 | Surgery | $716 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $313,390 | 51 |
| 99214 | Office o/p est mod 30 min | $77,790 | 51 |
| 98941 | Chiropract manj 3-4 regions | $57,996 | 24 |
| 99391 | Per pm reeval est pat infant | $42,737 | 25 |
| 99392 | Prev visit est age 1-4 | $41,434 | 26 |
| 99393 | Prev visit est age 5-11 | $29,570 | 16 |
| 99394 | Prev visit est age 12-17 | $20,305 | 13 |
| 98940 | Chiropract manj 1-2 regions | $1,344 | 2 |
| 99177 | Ocular instrumnt screen bil | $1,000 | 17 |
| 99202 | Office o/p new sf 15 min | $652 | 1 |
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.
