Newport Medicaid providers billed $74,886 for Evaluation and Management services in 2024

Newport Medicaid providers submitted $74,886 in claims for Evaluation and Management services in 2024, U.S. Department of Health and Human Services Medicaid Provider Spending data shows. This was an 86.4% increase compared to 2023, when $40,166 was billed for the same service category.

Medicaid, a public health insurance program administered by states and funded by both federal and state governments, provides coverage to low-income individuals and families, seniors, children, and people with disabilities. It is among the largest segments of the U.S. health care system.

Because Medicaid is funded by taxpayers, changes in local billing reflect how public health care funds are distributed in each community.

The “Evaluation and Management” category encompasses a range of Medicaid-billed services distinguished by the care type provided, based on standardized HCPCS and CPT code groupings. This analysis assigned each billing code to one service category with consistent code prefixes and numeric intervals, so that related services are evaluated together without overlapping counts, maintaining accurate rankings year over year.

Although spending increased in several service categories, Evaluation and Management was the third-largest Medicaid payment category in Newport for 2024.

For Pennsylvania as a whole, Evaluation and Management stood as the fourth-highest category in Medicaid payments in 2024.

Looking at the five-year period preceding 2024, Evaluation and Management Medicaid payments in Newport rose by $73,346—a 4,762.7% jump. Major year-over-year increases occurred in 2021 and 2023.

While payments for Evaluation and Management care were recorded throughout Newport, they were heavily concentrated in specific ZIP codes. In 2024, ZIP code 17074 accounted for $74,885 in Medicaid payments related to Evaluation and Management—the top ZIP code and making up 100% of the city’s total for this category.

Payment levels within the Evaluation and Management category were similarly concentrated among a small set of billing codes.

To compare, payments for Evaluation and Management services in Newport went up 86.4% between 2024 and 2023, while overall Medicaid billing for all service categories in the city increased by 65.3% during the same timeframe.

Centers for Medicare & Medicaid Services data show that combined federal and state Medicaid spending hit approximately $871.7 billion in fiscal year 2023, representing about 18% of all national health expenditures. This figure has climbed significantly from $613.5 billion in 2019, before the COVID-19 pandemic.

This uptick means spending grew roughly 40% over a few years, primarily due to higher enrollment and use during and after the pandemic.

Lawmakers’ recent federal budget legislation under the Trump administration included measures to trim federal Medicaid funding and reshape the program. The “One Big Beautiful Bill Act,” enacted in 2025, is set to cut federal Medicaid funding by more than $1 trillion over the next 10 years. It introduces new work requirements and increased cost-sharing, changes likely to reduce access and payments for certain beneficiaries. As a result, states are expected to incur higher Medicaid costs, even as tens of millions of Americans remain covered under the program.

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.