Livingston Medicaid providers billed $592,339 for Evaluation and Management services in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 13.1% increase compared to 2023, when claims for the category totaled $523,523.
Medicaid is a state-run public health insurance program funded jointly by federal and state governments. The program covers low-income individuals and families, seniors, children, and people with disabilities, making it one of the largest segments of the U.S. health care system.
Since Medicaid payments are taxpayer-funded, shifts in local billing levels highlight how community public health care dollars are spent.
The Evaluation and Management category represents services billed to Medicaid based on care type, defined by standardized HCPCS and CPT code ranges. Each billing code was grouped into a single service category for this analysis, using consistent prefixes and numeric sequences to enable detailed tracking of similar services while ensuring results are not double-counted and maintaining accurate rankings over time.
Medicaid spending increased in several categories, with Evaluation and Management ranking second in the city for total payments in 2024.
Statewide, Evaluation and Management ranked second in California by total Medicaid payments for 2024.
Over the five years before 2024, Medicaid payments connected to the Evaluation and Management category in Livingston rose $291,071, or 96.6%. Periods of accelerated spending were especially notable in 2022 and 2023.
Although these payments supported care throughout the city, they were concentrated in a small number of ZIP codes. For 2024, ZIP code 95334 accounted for all $592,339 of Evaluation and Management Medicaid payments, totaling 100% of the local category.
Within the Evaluation and Management grouping, most Medicaid payment totals came from a small number of individual billing codes.
Year over year, Medicaid payments for Evaluation and Management in Livingston increased 13.1% from 2023 to 2024, while total citywide Medicaid claims for all categories climbed 131.4% in the same window.
According to the Centers for Medicare & Medicaid Services, combined federal and state spending for Medicaid was about $871.7 billion in fiscal year 2023—roughly 18% of total national health expenditures, which was a sharp increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This growth reflects an approximate increase of 40% over several years, mainly due to rising enrollment and increased service use during and after the pandemic.
Federal budget measures under the Trump administration have contained substantial plans to reduce federal Medicaid funding while changing the program’s structure. The “One Big Beautiful Bill Act,” signed in 2025, is projected to reduce federal Medicaid spending by more than $1 trillion over the next 10 years and introduces changes like work requirements and increased cost-sharing, potentially limiting coverage and funding for some. These changes could place greater cost burdens on states and slow the expansion of federal Medicaid support, though the program continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $301,267 | -27.4% |
| 2021 | $258,454 | -14.2% |
| 2022 | $471,213 | 82.3% |
| 2023 | $523,522 | 11.1% |
| 2024 | $592,339 | 13.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $8,804,746 | 85.4% |
| 2 | Evaluation and Management | $592,339 | 5.7% |
| 3 | Medicine Services and Procedures | $515,860 | 5% |
| 4 | Dental Services | $155,951 | 1.5% |
| 5 | Surgery | $137,465 | 1.3% |
| 6 | Pathology and Laboratory Procedures | $48,635 | 0.5% |
| 7 | Procedures / Professional Services | $36,583 | 0.4% |
| 8 | Alcohol and Drug Abuse Treatment | $12,226 | 0.1% |
| 9 | Medical And Surgical Supplies | $1,316 | <0.1% |
| 10 | Drugs Administered Other than Oral Method | $411 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $241,010 | 149 |
| 99213 | Office o/p est low 20 min | $198,648 | 161 |
| 99394 | Prev visit est age 12-17 | $30,283 | 42 |
| 99395 | Prev visit est age 18-39 | $19,459 | 44 |
| 99393 | Prev visit est age 5-11 | $16,655 | 37 |
| 99392 | Prev visit est age 1-4 | $16,231 | 40 |
| 99204 | Office o/p new mod 45 min | $14,171 | 29 |
| 99391 | Per pm reeval est pat infant | $13,041 | 24 |
| 99212 | Office o/p est sf 10 min | $10,141 | 61 |
| 99396 | Prev visit est age 40-64 | $8,965 | 52 |
| 99173 | Visual acuity screen | $5,949 | 78 |
| 99203 | Office o/p new low 30 min | $4,079 | 13 |
| 99188 | App topical fluoride varnish | $3,679 | 17 |
| 99215 | Office o/p est hi 40 min | $3,462 | 6 |
| 99401 | Prev med cnsl indiv apprx 15 | $3,177 | 11 |
| 99308 | Sbsq nf care low mdm 20 | $1,898 | 11 |
| 99309 | Sbsq nf care moderate mdm 30 | $968 | 5 |
| 99211 | Off/op est may x req phy/qhp | $502 | 11 |
| 99384 | Prev visit new age 12-17 | $12 | 1 |
| 99499 | Unlisted e&m service | $0 | 2 |
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.
