Medicaid Evaluation and Management payments in Benson climb 1.5% to $760,740 in 2024

In 2024, Medicaid providers in Benson submitted $760,740 in claims for Evaluation and Management services, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. That amount was a 1.5% increase from 2023, when providers claimed $749,289 for the same service group.

Medicaid, a state-operated and jointly federal- and state-financed public health insurance program, serves low-income people and families, seniors, children, and those with disabilities, which makes it a major component of America’s health care system. More information about Medicaid funding is available from the Commonwealth Fund.

Because Medicaid expenditures are taxpayer-funded, shifts in local billing levels demonstrate how health care expenses are distributed within the community.

The “Evaluation and Management” category encompasses groups of Medicaid-billed services defined by care type, based on established HCPCS and CPT code designations. For this report, each billing code was categorized by service group using uniform code prefixes and numeric ranges, permitting analysis of related services without duplicate counting and to maintain precise rankings over multiple years.

Evaluation and Management led all Medicaid service categories in Benson by total payments in 2024, seeing increases across several categories.

Statewide in North Carolina, the Evaluation and Management category held the second spot for total Medicaid payments in 2024.

In Benson, payments for Evaluation and Management climbed by $388,169, or 104.2%, across the five-year period ending in 2024. The fastest year-over-year growth was noted in 2021 and 2022.

While Evaluation and Management services were used throughout Benson, Medicaid payments mostly came from a few ZIP codes. In 2024, ZIP code 27504 accounted for $760,739 in this category, representing 100% of Benson’s Medicaid payments linked to Evaluation and Management services that year.

Within the Evaluation and Management group, just a handful of specific billing codes drove most of the Medicaid payments.

For context, Evaluation and Management payments in Benson were up 1.5% between 2024 and 2023, compared to a 7% increase across all Medicaid claim categories in the city during that time.

Data from the Centers for Medicare & Medicaid Services show combined federal and state Medicaid spending topped $871.7 billion in fiscal year 2023, making up roughly 18% of total U.S. health care expenses, and a jump from about $613.5 billion in 2019, just before the COVID-19 pandemic.

This rise marks approximately 40% growth in several years, largely due to increased enrollment and higher service use during and following the pandemic period.

Recent federal budget measures under the Trump administration included major proposals to reduce federal Medicaid contributions and overhaul the program. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to cut over $1 trillion from federal Medicaid spending in the coming decade, implementing work requirements and extra cost-sharing which may limit coverage and funding for some enrollees. These changes are projected to increase state burden and moderate federal Medicaid growth, while the program continues to cover tens of millions nationwide.

Note: HCPCS codes are provided to illustrate the category. Totals and rankings in this report use standardized service groupings, not individual billing codes.

Data in this article were sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original data can be accessed here.