In 2024, Medicaid providers in Hays billed $139,438 for Evaluation and Management services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That figure represents a 44.1% increase compared to 2023, when $96,790 was billed for the same services.
Medicaid is a state-administered public health insurance program supported by both federal and state funding. The program covers low-income people and families, seniors, children, and those with disabilities, making it a core component of the U.S. health care system.
Since Medicaid payments are taxpayer funded, shifts in local billing indicate how public health care resources are distributed in a given area.
The Evaluation and Management category includes groups of Medicaid-billed services defined by the type of care delivered, organized using standardized HCPCS and CPT code groupings. For this report, each billing code is included in a single service category based on consistent code patterns, ensuring accurate tracking and rankings with no double counting.
Evaluation and Management received the highest total Medicaid payments among all service categories in Hays in 2024.
Statewide in North Carolina, Evaluation and Management was the second-highest Medicaid payment category by total payments in 2024.
From 2019 through 2024, Medicaid payments in Hays tied to Evaluation and Management increased by $75,852, or 119.3%. Payments rose significantly in certain periods, especially in 2021 and 2022.
Payments for Evaluation and Management were distributed throughout Hays, but most funds went to a small number of ZIP codes. In 2024, ZIP code 28635 led with $139,437 in Medicaid payments, representing 100% of the total for Evaluation and Management that year in the city.
Within Evaluation and Management, a few individual billing codes received much of the Medicaid payment activity.
Between 2024 and 2023, payments in Hays for Evaluation and Management rose by 44.1%, mirroring the 44% growth seen across all Medicaid claim types in the city during the same time frame.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending totaled about $871.7 billion for fiscal 2023, making up roughly 18% of national health expenditures, an increase from $613.5 billion in 2019, pre-pandemic.
This represents an approximate 40% increase in a few years, mainly due to expanded enrollment and higher use during and after the COVID-19 pandemic.
Recent federal budget measures enacted under the Trump administration brought forward significant potential cuts to Medicaid and changes to its structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid funding by over $1 trillion over the next decade and creates new policies, such as work requirements and greater cost-sharing, that may reduce both coverage and funding for certain groups. These policies are projected to transfer more Medicaid costs to states and cap the growth of federal support, all while Medicaid continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $63,586 | -18.3% |
| 2021 | $90,043 | 41.6% |
| 2022 | $93,391 | 3.7% |
| 2023 | $96,789 | 3.6% |
| 2024 | $139,437 | 44.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $139,437 | 10<0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $113,777 | 48 |
| 99199 | Unlisted special svc px/rprt | $21,147 | 12 |
| 99213 | Office o/p est low 20 min | $4,046 | 3 |
| 99212 | Office o/p est sf 10 min | $466 | 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.
