Elkland Medicaid providers billed $786 for Evaluation and Management services in 2024, up nearly 20%

In 2024, Medicaid providers in Elkland billed $786 for Evaluation and Management services, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total reflects a 19.8% rise over 2023, when providers submitted $656 in claims for this service category.

Medicaid is a public insurance initiative administered by states and jointly financed by federal and state governments. It serves low-income individuals, families, children, seniors, and people with disabilities, making it a major component of the national health care system.

Because Medicaid funding originates from taxpayers, shifts in local billing demonstrate how public health dollars are spent in each community.

The “Evaluation and Management” category includes Medicaid-billed services classified by type of care, based on standardized HCPCS and CPT code groupings. Each billing code used in the analysis was assigned to a single category using consistent code prefixes and numeric ranges, ensuring related services were grouped together without double counting and allowing for accurate year-over-year ranking.

Although Medicaid expenditures grew across multiple categories, Evaluation and Management ranked second in Elkland for total Medicaid payments in 2024.

In Pennsylvania overall, Evaluation and Management stood as the fourth-highest category for Medicaid payments in 2024.

From 2020 through 2024, Medicaid spending tied to Evaluation and Management in Elkland increased by $786, or 0%. Spending accelerated at certain points, with notable year-on-year increases noted for 2023 and 2022.

While funds for Evaluation and Management services were distributed throughout Elkland, the highest payments were concentrated within a small set of ZIP codes. In 2024, ZIP code 16920 accounted for $786 in Evaluation and Management Medicaid payments. Altogether, the leading ZIP code represented 100% of all local Medicaid payments in this category for the year.

Within the Evaluation and Management category, Medicaid payments were focused among a small group of individual billing codes.

Between 2024 and 2023, Medicaid payments to this category in Elkland increased by 19.8%, compared to a 44% change across all Medicaid claim categories in the city during the same period.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending reached approximately $871.7 billion in fiscal year 2023, representing about 18% of national health care expenditures. This is up from $613.5 billion in 2019, before the COVID-19 pandemic.

This growth reflects an increase of about 40% in several years, mostly due to expanded enrollment and greater use of services during and after the pandemic.

Recent federal budget measures during the Trump administration have included major proposals to reduce federal Medicaid funding and reform the program. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is projected to reduce federal Medicaid spending by over $1 trillion in the next decade. The act introduces changes such as work requirements and higher cost-sharing that could decrease coverage and funding for certain beneficiaries. These changes are expected to transfer more costs to states while restricting federal Medicaid growth, even as the program continues to serve millions of Americans.

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.