In 2024, Medicaid providers in Stayton billed $2,204,455 for services categorized under Evaluation and Management, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 5.9% increase from 2023, when claims for these services totaled $2,081,593.
Medicaid is a state-administered public health insurance program that is jointly financed by federal and state governments. It provides coverage to low-income families and individuals, children, seniors, and people with disabilities, making it a core component of the U.S. health care system.
Because Medicaid spending is funded by taxpayers, shifts in local billing patterns highlight how public health dollars are used within the community.
The “Evaluation and Management” category includes a collection of Medicaid-billed services distinguished by type of care and organized using standard HCPCS and CPT code groupings. For this review, each billing code was assigned to just one service category based on code prefixes and number ranges, so related services could be grouped together while avoiding duplicate counts and ensuring accurate year-over-year comparisons.
Although Medicaid spending climbed in various service categories, Evaluation and Management ranked as the top category in Stayton for total Medicaid payments during 2024.
At the state level, Evaluation and Management was also the highest ranking category for Medicaid payments in Oregon in 2024.
Between 2019 and 2024, Medicaid payments related to Evaluation and Management in Stayton grew by $1,082,571, representing a 96.5% increase. Some years, such as 2022 and 2021, saw especially significant annual increases in expenditures.
While funds for Evaluation and Management were distributed citywide, much of the spending was concentrated within specific ZIP codes. In 2024, ZIP code 97383 accounted for $2,204,455 in Medicaid payments in this category. Collectively, the leading ZIP code made up 100% of all Medicaid Evaluation and Management payments in Stayton for the year.
Most Medicaid payments in this service category were based on a small group of individual billing codes.
In a comparison of annual growth, Medicaid payments for Evaluation and Management services in Stayton rose by 5.9% from 2023 to 2024. This is contrasted with a 9.7% increase across all Medicaid claim categories in the city in the same period.
The Centers for Medicare & Medicaid Services reports that nationwide, federal and state Medicaid spending reached about $871.7 billion in fiscal year 2023, representing approximately 18% of all national health expenditures. This is a substantial rise from $613.5 billion in 2019, before the COVID-19 pandemic.
This growth—about 40% over several years—has been fueled largely by increased enrollment and higher utilization during and after the pandemic period.
Major federal budget legislation passed during the Trump administration included efforts to limit federal Medicaid funding and alter program structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid outlays by more than $1 trillion over the next decade. It also establishes measures like work requirements and greater cost-sharing, potentially shrinking coverage and funding for some recipients. These changes are expected to transfer more responsibility to states and may slow federal Medicaid growth, even as millions continue to depend on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,121,883 | -45.7% |
| 2021 | $1,410,792 | 25.8% |
| 2022 | $2,021,556 | 43.3% |
| 2023 | $2,081,593 | 3% |
| 2024 | $2,204,455 | 5.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $2,204,455 | 66.7% |
| 2 | Medicine Services and Procedures | $697,364 | 21.1% |
| 3 | Radiology Procedures | $131,386 | 4% |
| 4 | Pathology and Laboratory Procedures | $119,623 | 3.6% |
| 5 | Ambulance and Other Transport Services and Supplies | $100,634 | 3% |
| 6 | Surgery | $32,738 | 1% |
| 7 | Drugs Administered Other than Oral Method | $12,214 | 0.4% |
| 8 | Medical And Surgical Supplies | $4,040 | 0.1% |
| 9 | Temporary Codes | $1,128 | <0.1% |
| 10 | Procedures / Professional Services | $735 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99283 | Emergency dept visit low mdm | $1,138,661 | 191 |
| 99284 | Emergency dept visit mod mdm | $693,517 | 118 |
| 99285 | Emergency dept visit hi mdm | $137,481 | 16 |
| 99282 | Emergency dept visit sf mdm | $107,280 | 44 |
| 99214 | Office o/p est mod 30 min | $51,702 | 97 |
| 99213 | Office o/p est low 20 min | $36,007 | 80 |
| 99204 | Office o/p new mod 45 min | $16,362 | 8 |
| 99281 | Emr dpt vst mayx req phy/qhp | $8,986 | 6 |
| 99203 | Office o/p new low 30 min | $4,301 | 4 |
| 99215 | Office o/p est hi 40 min | $3,540 | 8 |
| 99385 | Prev visit new age 18-39 | $1,778 | 1 |
| 99396 | Prev visit est age 40-64 | $1,599 | 1 |
| 99212 | Office o/p est sf 10 min | $1,227 | 8 |
| 99173 | Visual acuity screen | $924 | 18 |
| 99406 | Behav chng smoking 3-10 min | $726 | 5 |
| 99443 | $357 | 1 |
Note: HCPCS codes are provided to show context within the category. The totals and rankings mentioned in this article are based on broader standardized service groupings, not on individual billing codes.
The information in this article comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Source data is available here.
