Evaluation and Management Medicaid payments total $15,765 in Vandalia for 2024, rising 28%

Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows Medicaid providers in Vandalia billed $15,765 for Evaluation and Management services in 2024. This figure reflects a 28% rise from 2023, when claims for these services amounted to $12,317.

Medicaid, a public health insurance initiative administered by each state and jointly financed by the federal and state governments, provides coverage for low-income families and individuals, seniors, children, and those with disabilities and represents a major component of U.S. health care.

Since Medicaid is funded by taxpayers, fluctuations in local claim activity are indicators of how public health funds are distributed within each community.

The Evaluation and Management designation covers a selection of Medicaid-billed services organized by specific care types, with definitions based on established HCPCS and CPT coding classifications. For this review, service codes were sorted into main categories using identified prefixes and number ranges, enabling grouped analysis without double counting and allowing for consistent rankings over time.

Although expenditures in multiple service groups increased, Evaluation and Management generated the highest Medicaid total payout in Vandalia for 2024.

Statewide, Evaluation and Management ranked second in total Medicaid reimbursements for Missouri in 2024.

Between 2020 and 2024, Medicaid spending on Evaluation and Management services in Vandalia increased by $16,070, marking a 50.5% growth. There were periods of more rapid acceleration, with significant annual gains reported in both 2023 and 2022.

While these services were available citywide, Medicaid payments were notably concentrated in a few ZIP codes. In 2024, ZIP code 63382 reported $15,764 in Evaluation and Management payments, comprising the entirety of Medicaid expenditures for this category in Vandalia that year.

A small selection of billing codes accounted for most Medicaid spending within the Evaluation and Management classification.

When comparing categories, Evaluation and Management-related Medicaid payments in Vandalia climbed 28% from 2023 to 2024, compared with a 41.1% rise across all Medicaid claims in the city in the same timeframe.

According to the Centers for Medicare & Medicaid Services, joint state and federal Medicaid spending reached approximately $871.7 billion in fiscal 2023, about 18% of national health care spending, rising from around $613.5 billion in 2019, before the COVID-19 pandemic.

This represents around a 40% increase within a short period, attributed primarily to rising enrollment and service utilization during and after the pandemic.

Major federal budget initiatives enacted under the Trump administration contained proposals to overhaul the Medicaid program and reduce federal support. The “One Big Beautiful Bill Act,”, signed into law in 2025, is estimated to lower federal Medicaid spending by more than $1 trillion over 10 years and has added measures including work requirements and greater cost-sharing, which may lessen funding and coverage for certain users. These adjustments are anticipated to increase the share of costs borne by states and to moderate federal Medicaid support growth, despite ongoing program enrollment among 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.