Forksville Medicaid providers submitted claims totaling $3,193 in 2024 for Evaluation and Management services, the U.S. Department of Health and Human Services Medicaid Provider Spending database reports. This amount represents a significant rise—276.5%—from the $848 billed for similar services the prior year.
Medicaid, a joint federal-state health program, provides insurance to low-income groups, including families, seniors, children, and individuals with disabilities. This program is a substantial part of the nation’s health care system, funded through a partnership between the federal and state governments.
Shifts in Medicaid payment levels in areas like Forksville reflect how public dollars for health care are deployed locally, since the program is taxpayer funded.
The Evaluation and Management classification was applied to a range of services based on systematic HCPCS and CPT code groups. Each billing code in this analysis was designated to one category through its code range and prefix, aligning services by type, eliminating overlap, and ensuring correct ranking trends year over year.
Forksville registered Evaluation and Management as the top category for Medicaid payments among all service groups in 2024, with total spending exceeding all others.
Statewide, Pennsylvania placed Evaluation and Management fourth in terms of total Medicaid payment categories during 2024.
In the five years before 2024, local Evaluation and Management-linked Medicaid payments in Forksville grew by $3,193, which equals an overall 0% increase. The highest year-over-year increases occurred during the periods that included 2023 and 2022.
Payments for these services, while distributed throughout the city, were primarily restricted to a small cluster of ZIP codes. Forksville’s 18616 ZIP code alone comprised $3,192 of the Evaluation and Management Medicaid payments in 2024, making up 100% of all claims within the category that year.
A limited selection of billing codes accounted for most Medicaid disbursements in the Evaluation and Management area.
Evaluation and Management Medicaid bills in Forksville rose 276.5% between 2024 and 2023, just outpacing the 276.4% overall climb across all Medicaid claim categories citywide over that same segment.
Centers for Medicare & Medicaid Services data indicate that Medicaid expenditures totaled about $871.7 billion nationwide in the 2023 fiscal year, representing about 18% of total U.S. health expenditures and a significant rise from $613.5 billion in 2019, the period prior to the COVID-19 pandemic.
This upward trend marks nearly 40% growth over several years, attributed mainly to swelling program enrollment and greater usage during—and following—the pandemic.
Federal budget reforms during the Trump administration introduced major concepts to trim federal Medicaid contributions and reorganize how the program is administered. The “One Big Beautiful Bill Act,” adopted in 2025, for example, is projected to cut federal Medicaid outlays by more than $1 trillion over 10 years, including initiatives such as work requirements and higher patient cost-sharing—measures that could reduce both program coverage and federal funding support and potentially increase states’ cost responsibility for Medicaid.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2023 | $848 | – |
| 2024 | $3,192 | 276.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $3,192 | 10<0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99309 | Sbsq nf care moderate mdm 30 | $3,192 | 8 |
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.
