Medicaid Evaluation and Management payments in Renovo climb to $21,902 in 2024

Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show that in 2024, Medicaid providers in Renovo billed $21,902 for Evaluation and Management services. This was a 34.3% jump from 2023, when claims totaled $16,309 for the same category.

Medicaid is a government health insurance program operated by the states and funded jointly by federal and state governments. It provides coverage to low-income individuals, families, seniors, children, and those with disabilities, making it a cornerstone of the U.S. health care system.

Since taxpayer dollars fund Medicaid payments, shifts in local claim amounts highlight changes in the allocation of public health care resources within a community.

The “Evaluation and Management” category includes a range of services billed to Medicaid, grouped by the type of care based on standardized HCPCS and CPT code classifications. In this report, each billing code is assigned to a single service category by code prefix and number range, which allows for the comparison of related services, avoids double counting, and preserves data integrity in rankings over time.

While Medicaid spending grew in several categories, Evaluation and Management services represented the highest amount paid by Medicaid in Renovo in 2024.

Statewide in Pennsylvania, Evaluation and Management ranked fourth among categories for total Medicaid payments in 2024.

Between the five years preceding 2024, Medicaid payments for Evaluation and Management in Renovo grew by $19,522, which equals an 820.3% increase. Some years saw sharper growth, with significant annual increases in 2021 and 2022.

Although spending for Evaluation and Management care was registered citywide, payments were largely concentrated in a small number of ZIP codes. In 2024, ZIP code 17764 accounted for $21,901 in Medicaid payments in this category. Collectively, this ZIP code made up 100% of all Medicaid spending for Evaluation and Management services in Renovo during the year.

Within this category, Medicaid payments focused on a relatively few specific billing codes.

For context, from 2023 to 2024, Medicaid payments for Evaluation and Management in Renovo rose by 34.3%. In comparison, all Medicaid categories in the city saw a 30.4% increase during the same time frame.

According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid expenditures reached about $871.7 billion in fiscal year 2023, making up approximately 18% of total national health spending. This was a sharp rise from around $613.5 billion in 2019, before the onset of COVID-19.

This marks growth of about 40% within a few years, driven mainly by expanded enrollment and higher health care utilization before, during, and after the pandemic.

Under recent budget legislation signed during the Trump administration, major proposals were enacted to reduce federal Medicaid funds and overhaul the program. For example, the “One Big Beautiful Bill Act,” signed in 2025, is estimated to cut more than $1 trillion in federal Medicaid spending over the next decade. It also introduces requirements such as work conditions and greater cost-sharing, which could affect coverage and funding for some recipients. These policies are expected to shift financial responsibility to the states and restrict federal Medicaid growth, even as the program continues to cover tens of millions nationwide.

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.