Elmira Medicaid spending on evaluation and management services rises to $5,642 in 2024

In 2024, providers in Elmira billed Medicaid $5,642 for Evaluation and Management services, gathering data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 208.6% jump from 2023, during which providers claimed $1,828 for services in this category.

Medicaid, a state-administered health insurance program jointly financed by federal and state governments, covers low-income residents, seniors, children, and individuals with disabilities and stands as one of the primary components of U.S. health care.

Shifts in Medicaid billing indicate changes in how public health care funds, which originate from taxpayers, are distributed in a specific community.

The “Evaluation and Management” classification includes a set of Medicaid-billed services that are grouped by care type, using standardized HCPCS and CPT codes. For the purposes of this analysis, each billing code is placed in a separate service category based on code prefixes and numbered ranges, which reduces overlap and maintains correct rankings over time.

Evaluation and Management was the second-highest Medicaid spending category in Elmira for 2024, though payment growth was seen across several service types.

Statewide, Evaluation and Management was the leading service category for total Medicaid payments in Oregon during 2024.

In the five years prior to 2024, Medicaid disbursements for Evaluation and Management services in Elmira grew by $5,642, a change of 0%. However, growth rates accelerated at points, with sharp yearly increases seen for 2022 and 2022.

Although spending was distributed across Elmira, most Evaluation and Management payments in 2024 came from a small group of ZIP codes. In particular, the 97437 ZIP code saw Medicaid payments total $5,642. Altogether, the top 1 ZIP codes accounted for the entire Medicaid outlay in this category for Elmira that year.

A concentrated set of billing codes accounted for most Medicaid payments within Evaluation and Management services.

To compare, between 2024 and 2023, the city’s Medicaid payments for Evaluation and Management grew by 208.6%, while overall Medicaid claims across all service groups in Elmira increased by 21.1% during that period.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid funding reached approximately $871.7 billion in fiscal year 2023, which represented around 18% of nation-wide health spending — up notably from $613.5 billion in 2019, before the COVID-19 pandemic.

This equates to a near-40% increase over a few years, with most growth attributed to increased enrollment and greater use of services during and after the pandemic.

Federal budget changes introduced during the Trump administration have included significant plans to cut Medicaid funding and modify program rules. Notably, the “One Big Beautiful Bill Act,” approved in 2025, is expected to reduce federal Medicaid support by over $1 trillion over 10 years and establish extra requirements for eligibility and larger out-of-pocket expenses—trends that could restrict coverage for various populations and lead states to shoulder more Medicaid costs even as the program remains vital to millions.

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.