Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows Medicaid providers in Fort Ashby billed $2,894 for Evaluation and Management services in 2024. This represents a 39.6% increase from 2023, when claims for these services reached $2,073.
Medicaid, a joint state and federally funded public health insurance program, serves low-income people and families, seniors, children, and individuals with disabilities, playing a key role in the U.S. health care system. More details are available from the Commonwealth Fund.
Since Medicaid payments are sourced from taxpayers, fluctuations in local billing levels track how communities allocate public health care funds.
The “Evaluation and Management” category includes certain Medicaid-billed services defined by specific care types, based on recognized HCPCS and CPT code groupings. For this review, each billing code was grouped within a single service category using consistent prefixes and number ranges to allow similar services to be tracked together, minimizing double counting and maintaining consistent rankings over time.
Evaluation and Management was ranked second by total Medicaid payments among service categories in Fort Ashby during 2024, among several categories showing growth in spending.
Statewide, Evaluation and Management also held the second spot for Medicaid payment totals in West Virginia for 2024.
From 2019 to 2024, Medicaid payments for Evaluation and Management in Fort Ashby rose by $2,894, amounting to a 0% change over five years. Growth in spending accelerated in some periods, with significant annual increases recorded during 2022 and 2023.
While spending in this category was spread throughout Fort Ashby, payments were heavily concentrated in just a few ZIP codes. In 2024, ZIP code 26719 accounted for $2,894, representing 100% of all local Medicaid payments in Evaluation and Management for that year.
Payments within the Evaluation and Management category were focused in a small number of billing codes.
When measured against all Medicaid claim categories in Fort Ashby, payments in the Evaluation and Management category increased by 39.6% from 2023 to 2024, compared to a 42.1% increase across all claim types in the city during this period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached approximately $871.7 billion for the 2023 fiscal year, making up about 18% of all national health expenditures. This marks a significant rise from roughly $613.5 billion in 2019, before the onset of the COVID-19 pandemic.
This jump represents about 40% growth in only a handful of years, largely due to increased enrollment and service utilization both during and following the pandemic.
Recent federal budget measures under the Trump administration have brought forward extensive proposals to cut federal Medicaid funds and alter the program. As an example, the “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid spending by over $1 trillion over 10 years, introducing provisions like work requirements and higher cost-sharing. Such policies may decrease funding and coverage for certain groups, shifting more responsibility to states and slowing the increase of federal support, while the program continues to cover millions nationally.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $0 | – |
| 2021 | $0 | – |
| 2022 | $1,365 | 284339.6% |
| 2023 | $2,073 | 51.9% |
| 2024 | $2,894 | 39.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $72,023 | 96.1% |
| 2 | Evaluation and Management | $2,894 | 3.9% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $2,742 | 14 |
| 99213 | Office o/p est low 20 min | $152 | 1 |
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.
