Oxford sees 4.5% increase in Medicaid Evaluation and Management payments in 2024

In 2024, Oxford Medicaid providers billed $5,045,843 for services within the Evaluation and Management category, as reported by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount reflects a 4.5% growth compared with 2023, when providers submitted $4,830,439 in claims for the same services.

Medicaid is a public insurance program operated by states and funded jointly by state and federal governments. It serves low-income individuals and families, seniors, children, and people with disabilities, making it one of the country’s largest health care programs.

Since Medicaid is taxpayer-funded, changes in local claims demonstrate how health funding is distributed within a community.

The “Evaluation and Management” category includes Medicaid-billed services grouped according to the nature of care, based on standardized HCPCS and CPT codes. For this study, each billing code was sorted into a single service category by using uniform code prefixes and numeric ranges, ensuring related services could be analyzed together, without double counting and allowing accurate rankings over time.

While multiple service categories saw increased Medicaid spending, Evaluation and Management ranked second by total Medicaid payments in Oxford in 2024.

Statewide in North Carolina, Evaluation and Management was also the second-largest category by Medicaid payments that year.

Between 2019 and 2024, Oxford’s Medicaid payments for Evaluation and Management services grew by $2,723,701, or 117.3%. During this period, some years—such as 2021 and 2022—saw especially sharp increases.

Spending on Evaluation and Management care in Oxford was distributed among various parts of the city but mostly concentrated in a small number of ZIP codes. In 2024, the 27565 ZIP code accounted for the full $5,045,842 billed under this category. The top ZIP code made up 100% of Medicaid payments for Evaluation and Management in Oxford that year.

Within this category, most Medicaid payments were tied to a relatively small set of individual billing codes.

For reference, Evaluation and Management payments in Oxford increased by 4.5% from 2023 to 2024, compared with a 1.7% rise for all Medicaid claim categories in the city over the same time period.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending was about $871.7 billion in fiscal 2023, comprising about 18% of national health spending—up from an estimated $613.5 billion in 2019, before the COVID-19 pandemic.

This represents growth of around 40% in several years, with enrollment gains and higher utilization during and after the pandemic as primary drivers.

Recent federal budget measures under the Trump administration have proposed major reductions in federal Medicaid funding and program restructuring. For example, the “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to trim over $1 trillion from federal Medicaid spending over the next decade, instituting policies such as work requirements and higher cost-sharing that could reduce funding and coverage for some enrollees. These modifications are expected to shift additional costs to states and slow the growth of federal support, even as Medicaid continues to cover tens of 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.