Providers delivering Medicaid-funded Evaluation and Management services in Grants billed $7,271,040 in 2024, U.S. Department of Health and Human Services Medicaid Provider Spending data show. This total was up 2.6% over 2023, when providers reported $7,086,372 in similar claims.
Medicaid, a public health insurance initiative, is administered by states and supported by both federal and state funding. It insures low-income groups, seniors, children, and people living with disabilities, and is one of the largest sources of coverage in the United States.
Because Medicaid draws from taxpayer funding, fluctuations in billing locally can highlight how a community’s public health dollars are spent.
The Evaluation and Management grouping includes Medicaid-billed services defined by care type, classified using unified HCPCS and CPT code groupings. For this report, billing codes were assigned to categories based on shared prefixes and numerical intervals to prevent double accounting and preserve accurate category rankings through the years.
Among all service groupings tracked, Evaluation and Management led all Medicaid payment categories in Grants during 2024.
Across New Mexico, the Evaluation and Management service grouping ranked third statewide by Medicaid payments for 2024.
Looking back over the five years to 2024, Medicaid payments for Evaluation and Management in Grants increased by $4,364,369—an expansion of 150.2%. Growth in spending was particularly significant in certain periods, including notable percent jumps in both 2022 and 2021.
Medicaid payments for Evaluation and Management care were distributed citywide, but most funds were concentrated in a small number of ZIP codes. In 2024, ZIP code 87020 received $7,271,039, accounting for 100% of Grants Medicaid payments linked to Evaluation and Management services that year.
A relatively small selection of individual billing codes captured most Medicaid spending within the Evaluation and Management category.
To compare, Medicaid payments for Evaluation and Management in Grants grew 2.6% from 2023 to 2024. In contrast, all Medicaid claim types citywide increased 10.1% during that same timeframe.
The Centers for Medicare & Medicaid Services report that total federal and state Medicaid spending was about $871.7 billion for fiscal year 2023. That represents almost 18% of total national health spending—a sharp jump from the approximately $613.5 billion reported in 2019, before the onset of COVID-19.
This growth—around 40% in just a few years—can be primarily attributed to greater enrollment and increased utilization during and after the pandemic.
Recent federal budget measures under the Trump administration proposed major reductions for Medicaid funding and additional program changes. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to trim federal Medicaid outlays by more than $1 trillion over the coming decade. New mandates such as work requirements and higher cost-sharing could reduce both coverage and funding for some recipients, shifting a greater share of costs to the states and slowing federal Medicaid spending, even as millions continue to rely on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $2,906,671 | 13.1% |
| 2021 | $3,954,871 | 36.1% |
| 2022 | $6,108,407 | 54.5% |
| 2023 | $7,086,372 | 16% |
| 2024 | $7,271,039 | 2.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $7,271,039 | 45.9% |
| 2 | Medicine Services and Procedures | $3,676,097 | 23.2% |
| 3 | National Codes Established for State Medicaid Agencies | $2,489,574 | 15.7% |
| 4 | Radiology Procedures | $730,226 | 4.6% |
| 5 | Pathology and Laboratory Procedures | $407,889 | 2.6% |
| 6 | Dental Services | $363,688 | 2.3% |
| 7 | Drugs Administered Other than Oral Method | $324,531 | 2% |
| 8 | Procedures / Professional Services | $284,827 | 1.8% |
| 9 | Alcohol and Drug Abuse Treatment | $116,769 | 0.7% |
| 10 | Durable Medical Equipment | $88,642 | 0.6% |
| 11 | Surgery | $68,632 | 0.4% |
| 12 | Temporary Codes | $22,990 | 0.1% |
| 13 | Administrative, Miscellaneous and Investigational | $754 | <0.1% |
| 14 | Medical And Surgical Supplies | $109 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99284 | Emergency dept visit mod mdm | $2,577,377 | 387 |
| 99285 | Emergency dept visit hi mdm | $1,672,902 | 303 |
| 99283 | Emergency dept visit low mdm | $968,591 | 122 |
| 99213 | Office o/p est low 20 min | $905,784 | 53 |
| 99214 | Office o/p est mod 30 min | $519,663 | 43 |
| 99282 | Emergency dept visit sf mdm | $324,299 | 12 |
| 99212 | Office o/p est sf 10 min | $50,085 | 11 |
| 99392 | Prev visit est age 1-4 | $47,642 | 13 |
| 99391 | Per pm reeval est pat infant | $43,165 | 12 |
| 99215 | Office o/p est hi 40 min | $40,059 | 12 |
| 99393 | Prev visit est age 5-11 | $36,747 | 11 |
| 99394 | Prev visit est age 12-17 | $27,135 | 8 |
| 99202 | Office o/p new sf 15 min | $16,912 | 7 |
| 99205 | Office o/p new hi 60 min | $15,677 | 6 |
| 99204 | Office o/p new mod 45 min | $8,197 | 4 |
| 99173 | Visual acuity screen | $7,346 | 10 |
| 99291 | Critical care first hour | $3,219 | 2 |
| 99203 | Office o/p new low 30 min | $2,263 | 1 |
| 99395 | Prev visit est age 18-39 | $2,219 | 1 |
| 99222 | 1st hosp ip/obs moderate 55 | $1,711 | 1 |
Note: HCPCS codes are provided for reference within each service grouping. Total payments and category rankings reflect standardized service groupings rather than individual billing codes.
Data referenced in this report is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Source data is available here.
