Reedsville Medicaid billing for Evaluation and Management services rises to $60,727 in 2024

Medicaid providers in Reedsville billed $60,727 for services classified under the Evaluation and Management category in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 56.3% climb compared with 2023, when the total for these services was $38,855.

Medicaid is a state-operated, federally and state-funded public health insurance program jointly supported by both levels of government. It covers low-income families and individuals, seniors, children, and people with disabilities, making it a significant component of the U.S. health care system.

Since Medicaid funds are sourced from taxpayers, fluctuations in local billing highlight how communities allocate public health spending.

The “Evaluation and Management” grouping comprises a variety of Medicaid services identified by the type of care provided, based on established HCPCS and CPT code categories. For this analysis, each billing code was consistently assigned to a single service group using shared code prefixes and ranges. That allowed services to be reviewed together while preventing double counting and ensuring accurate year-over-year comparisons.

While Medicaid spending rose across several service categories, Evaluation and Management had the highest total Medicaid payments in Reedsville for 2024.

Statewide in Pennsylvania, Evaluation and Management ranked fourth by total Medicaid payments in 2024.

From 2019 to 2024, Medicaid payments related to Evaluation and Management in Reedsville rose by $60,727, or 0%. Certain years saw especially notable growth, including marked year-over-year gains in 2023 and 2022.

Although care in the Evaluation and Management category occurred throughout the city, most Medicaid payments were focused in a small number of ZIP codes. ZIP code 17084 saw the highest such payments in 2024, at $60,727. This single ZIP code accounted for 100% of Evaluation and Management Medicaid payments in Reedsville that year.

Within the category, donations were largely attributed to only a limited set of specific billing codes.

To compare, between 2024 and 2023, Evaluation and Management Medicaid payments in Reedsville climbed 56.3%, while overall Medicaid claim payments citywide went up 85.2% during the same timeframe.

According to the Centers for Medicare & Medicaid Services, joint federal and state Medicaid expenditures totaled approximately $871.7 billion in fiscal year 2023. That represented roughly 18% of U.S. health spending, increasing sharply from about $613.5 billion in 2019, prior to the COVID-19 pandemic.

This change reflects a nearly 40% growth over just a few years, propelled primarily by expanded enrollment and greater utilization during and after the pandemic period.

Federal budget legislation during the Trump administration included significant proposals to trim federal Medicaid funding and alter how the program operates. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is expected to cut more than $1 trillion in federal Medicaid funding over 10 years and incorporates provisions like work requirements and increased cost-sharing. These measures may reduce coverage and funding for some recipients, pushing more costs to states and limiting future federal support, even as Medicaid continues to serve many 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.