Springfield sees $17,414,502 in Medicaid Evaluation and Management payments in 2024

In 2024, Medicaid providers in Springfield billed $17,414,502 for services falling under the Evaluation and Management category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represented a 9.4% jump from 2023, when claims for the same service totaled $15,921,865.

Medicaid is a public health insurance program administered by individual states and funded collaboratively by federal and state governments. The program covers people with low incomes, seniors, children and those with disabilities, making it a significant component of the U.S. health care landscape.

Since Medicaid is funded by taxpayers, fluctuations in local billing levels indicate how community health care resources are distributed.

The “Evaluation and Management” category encompasses a set of Medicaid-billed services defined by care type, referencing standard HCPCS and CPT code groups. In this analysis, billing codes were grouped into a single category using uniform code prefixes and number ranges, which enables comprehensive review of services by groupings without double-counting, maintaining accuracy in rankings over time.

While Medicaid spending rose for various service categories, payments for Evaluation and Management led all categories in Springfield by total Medicaid payments in 2024.

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

From 2019 through 2024, Medicaid outlays linked to Evaluation and Management services in Springfield climbed by $5,724,158, an increase of 49%. The growth rate accelerated in certain years, and sizeable year-over-year rises occurred in both 2023 and 2021.

Despite Evaluation and Management care being provided throughout Springfield, Medicaid payments concentrated in a handful of ZIP codes. In 2024, ZIP code 97477 reported $17,414,502 in these payments, with the top ZIP code accounting for 100% of Springfield’s category total that year.

Most Medicaid payments in the Evaluation and Management group focused on a select range of individual billing codes.

When compared to a 0.5% increase across all Medicaid claim categories overall in the city, the 9.4% rise in Evaluation and Management payments in Springfield between 2024 and 2023 stood out.

Data from the Centers for Medicare & Medicaid Services shows combined state and federal Medicaid spending reached about $871.7 billion nationwide in fiscal year 2023, comprising approximately 18% of all national health expenditures. This reflects a significant jump from $613.5 billion in 2019, before the COVID-19 pandemic.

The change amounts to roughly 40% growth over several years, fueled mainly by increasing enrollment and higher health care use through and following the pandemic.

Federal budget measures enacted under the Trump administration — including the “One Big Beautiful Bill Act,” which became law in 2025 — contain projected cuts of over $1 trillion in federal Medicaid spending over 10 years. Such legislation introduces new policies like work mandates and higher cost-sharing, potentially reducing coverage and funding for certain groups and transferring greater financial responsibility to the states. These moves are anticipated to moderate growth in federal Medicaid support while the program continues covering tens of millions of individuals.

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.