Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows Medicaid providers in Citrus Heights billed $326,359 for Evaluation and Management services in 2024. This amount was up 22.5% compared to 2023, when claims for the same services totaled $266,494.
Medicaid is a public health insurance initiative administered at the state level and jointly financed by federal and state governments. It provides health coverage for low-income individuals, families, seniors, children and people with disabilities, making it a significant component of the nation’s health care system.
Fluctuations in local Medicaid billing reflect how public health dollars are utilized within a community since these payments are taxpayer funded.
The “Evaluation and Management” classification encompasses Medicaid-billed services defined by care type and aligned with standardized HCPCS and CPT codes. For this analysis, each billing code has been placed into a single service category by code prefixes and numerical ranges, helping consolidate related services, avoid duplicate counting, and maintain accurate rankings over time.
Evaluation and Management was the seventh-highest Medicaid category by total payments in Citrus Heights in 2024, though Medicaid expenditures increased in several service areas.
Across California, Evaluation and Management ranked as the second-largest category for Medicaid payments in 2024.
Between 2019 and 2024, Medicaid payments connected to Evaluation and Management services in Citrus Heights rose by $128,920, or 65.3%. Notable annual growth occurred in certain years, including 2020 and 2021.
Spending on Evaluation and Management services was distributed throughout the city but concentrated in a small number of ZIP codes. In 2024, ZIP code 95621 accounted for $298,946, and 95610 saw $27,411 in Medicaid payments related to these services. Combined, these two ZIP codes represented 100% of the city’s Evaluation and Management Medicaid payments that year.
Payments within the Evaluation and Management group were further concentrated among a small set of billing codes.
For context, the 22.5% increase in Evaluation and Management Medicaid payments in Citrus Heights between 2024 and 2023 was larger than the 6.3% rise observed across all city Medicaid categories during that period.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid outlays reached about $871.7 billion in fiscal 2023, making up approximately 18% of national health expenditures. This reflects a sharp increase from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.
The nearly 40% increase in recent years is largely attributed to expanded enrollment and greater service utilization during and following the pandemic.
Major federal budget changes under the Trump administration have proposed significant Medicaid funding reductions and program modifications. The “One Big Beautiful Bill Act,” signed in 2025, is estimated to cut federal Medicaid spending by more than $1 trillion over 10 years. It introduces measures such as work mandates and increased cost-sharing, which could result in reduced coverage and funding for some recipients. These adjustments are expected to place more financial responsibility on states and curb federal Medicaid growth, while the program still supports tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $197,438 | 113.2% |
| 2021 | $281,589 | 42.6% |
| 2022 | $225,093 | -20.1% |
| 2023 | $266,494 | 18.4% |
| 2024 | $326,358 | 22.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Procedures / Professional Services | $6,366,620 | 37.1% |
| 2 | Alcohol and Drug Abuse Treatment | $4,365,675 | 25.4% |
| 3 | Temporary National Codes (Non-Medicare) | $2,955,470 | 17.2% |
| 4 | Medicine Services and Procedures | $1,174,270 | 6.8% |
| 5 | National Codes Established for State Medicaid Agencies | $1,017,160 | 5.9% |
| 6 | Dental Services | $892,078 | 5.2% |
| 7 | Evaluation and Management | $326,358 | 1.9% |
| 8 | Pathology and Laboratory Procedures | $24,181 | 0.1% |
| 9 | Ambulance and Other Transport Services and Supplies | $15,697 | 0.1% |
| 10 | Vision Services | $14,941 | 0.1% |
| 11 | Anesthesia | $8,015 | <0.1% |
| 12 | Surgery | $2,192 | <0.1% |
| 13 | Radiology Procedures | $1,894 | <0.1% |
| 14 | Drugs Administered Other than Oral Method | $1,097 | <0.1% |
| 15 | Medical And Surgical Supplies | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $84,526 | 24 |
| 99391 | Per pm reeval est pat infant | $42,841 | 11 |
| 99204 | Office o/p new mod 45 min | $31,702 | 36 |
| 99392 | Prev visit est age 1-4 | $28,032 | 12 |
| 99383 | Prev visit new age 5-11 | $24,204 | 10 |
| 99384 | Prev visit new age 12-17 | $23,065 | 10 |
| 99393 | Prev visit est age 5-11 | $19,459 | 11 |
| 99394 | Prev visit est age 12-17 | $18,155 | 11 |
| 99381 | Init pm e/m new pat infant | $14,881 | 11 |
| 99382 | Init pm e/m new pat 1-4 yrs | $14,460 | 10 |
| 99214 | Office o/p est mod 30 min | $12,272 | 40 |
| 99212 | Office o/p est sf 10 min | $6,941 | 13 |
| 99202 | Office o/p new sf 15 min | $2,989 | 1 |
| 99244 | Off/op cnsltj new/est mod 40 | $1,684 | 1 |
| 99203 | Office o/p new low 30 min | $602 | 1 |
| 99401 | Prev med cnsl indiv apprx 15 | $427 | 11 |
| 99408 | Audit/dast 15-30 min | $109 | 3 |
| 99199 | Unlisted special svc px/rprt | $0 | 1 |
| 99385 | Prev visit new age 18-39 | $0 | 6 |
| 99386 | Prev visit new age 40-64 | $0 | 2 |
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.