In 2024, Medicaid providers in East Los Angeles billed a total of $47,136 for services grouped under the Evaluation and Management category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total reflects a substantial increase of 63.3% from the $28,865 in claims for the same services reported in 2023.
Medicaid, a state-administered public insurance program jointly funded by state and federal governments, provides coverage for low-income people, seniors, children and those with disabilities. This makes it a major component of America’s health care infrastructure.
As taxpayer-funded payments, changes in Medicaid billing at the local level illustrate the allocation of public health care resources within a community.
The “Evaluation and Management” category includes a range of Medicaid-billed services defined by the type of patient care delivered, using standardized CPT and HCPCS code groupings. Each code was assigned to a single service stop in this study, using consistent code prefixes and numeric ranges to analyze related services together and maintain accurate comparative trends over time.
Medicaid spending in several categories increased, but Evaluation and Management represented the largest total Medicaid payments in East Los Angeles for 2024.
Statewide in California, Evaluation and Management placed second for total Medicaid payments that same year.
From the five years preceding 2024, Medicaid payments in East Los Angeles linked to the Evaluation and Management category grew by $47,136, or 0%. By period, spending spikes appeared in 2023 and 2022, showing periods of more rapid annual growth.
Though Evaluation and Management services were delivered across East Los Angeles, payment distribution was concentrated in a few ZIP codes. In 2024, ZIP code 90022 made up $47,135 in claims, representing 100% of the Medicaid payments for this service group in the area for that year.
Most Medicaid payments for Evaluation and Management were associated with a handful of specific billing codes in 2024.
Comparatively, the 63.3% rise in Evaluation and Management Medicaid payments in East Los Angeles from 2023 to 2024 outpaced the 32.6% change seen across all Medicaid service claim types in the city.
According to the Centers for Medicare & Medicaid Services, state and federal Medicaid spending together reached about $871.7 billion in fiscal 2023, comprising roughly 18% of the nation’s overall health expenditures—a sharp increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.
This increase, which totals around 40% over several years, is primarily attributed to higher enrollment numbers and increased service use during and after the pandemic period.
Recent federal budget actions passed during the Trump administration brought forward large-scale proposals aimed at reducing federal contributions to Medicaid and changing how the program is structured. The “One Big Beautiful Bill Act,” enacted in 2025, is set to cut more than $1 trillion in federal Medicaid funding over 10 years, introducing work requirements and greater cost-sharing expectations that could diminish coverage and resources for certain enrollees. These adjustments are projected to place increased financial responsibility on states, capping federal budget growth even as Medicaid continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2021 | $9,869 | – |
| 2022 | $16,297 | 65.1% |
| 2023 | $28,864 | 77.1% |
| 2024 | $47,135 | 63.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $47,135 | 50.2% |
| 2 | Pathology and Laboratory Procedures | $16,463 | 17.5% |
| 3 | Drugs Administered Other than Oral Method | $10,910 | 11.6% |
| 4 | Temporary National Codes (Non-Medicare) | $6,967 | 7.4% |
| 5 | Medical And Surgical Supplies | $6,959 | 7.4% |
| 6 | Procedures / Professional Services | $3,279 | 3.5% |
| 7 | Surgery | $2,128 | 2.3% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99212 | Office o/p est sf 10 min | $29,206 | 20 |
| 99202 | Office o/p new sf 15 min | $17,928 | 9 |
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.
