Ridgeway sees 3.5% increase in Medicaid Evaluation and Management payments in 2024

In 2024, Ridgeway Medicaid providers billed $131,103 for Evaluation and Management services, U.S. Department of Health and Human Services Medicaid Provider Spending data show. This amount is up 3.5% from the previous year, when providers filed $126,628 in claims for the same service group.

Medicaid, administered by the states and funded by both federal and state governments, offers health insurance to eligible low-income people, families, seniors, children and people with disabilities. As such, Medicaid plays a major role in the U.S. health care system.

Because Medicaid funding is drawn from taxpayer dollars, fluctuations in local billing reveal how communities allocate public health funds.

The “Evaluation and Management” designation encompasses a set of Medicaid services grouped by care type, aligned with standardized HCPCS and CPT codes. For this assessment, each billing code was linked to a single category based on uniform numerical ranges and code prefixes, grouping similar services while preventing duplicate counts and maintaining accurate rankings across periods.

While overall Medicaid spending increased among several categories, Evaluation and Management led Ridgeway for total Medicaid payments in 2024.

Statewide in Virginia, Evaluation and Management was the third-largest Medicaid payments category in 2024.

Looking over the five years to 2024, Ridgeway’s Medicaid payments for Evaluation and Management services grew by $21,628, a 14.2% increase. Some years saw faster growth, including significant changes in 2022 and 2020.

Spending for Evaluation and Management care was identified citywide, but a few ZIP codes accounted for most payments. In 2024, ZIP code 24148 saw the highest Medicaid payments for Evaluation and Management, reaching $131,102. The top ZIP code made up 100% of such Medicaid payments in Ridgeway for the year.

Within Evaluation and Management, Medicaid reimbursements were centered on a small number of specific billing codes.

For context, Ridgeway’s Medicaid payments tied to the Evaluation and Management category rose 3.5% between 2024 and the prior year, while all Medicaid claim categories in the city saw a 6% increase during the same period.

The Centers for Medicare & Medicaid Services reported that combined federal and state Medicaid spending totaled about $871.7 billion in fiscal 2023, making up approximately 18% of national health expenditures—an increase from $613.5 billion in 2019, before the COVID-19 pandemic.

This change amounts to almost 40% growth in several years, largely driven by more enrollees and increased use of services during and after the pandemic.

Recent federal legislation during the Trump administration included major proposals to cut federal Medicaid funding and change the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid spending by more than $1 trillion over the coming decade, with measures such as work requirements and greater cost-sharing that may affect coverage and funding for some participants. These moves are projected to transfer more costs to the states and restrain the growth of federal Medicaid support as the program continues serving millions across the nation.

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.