Dillsburg Medicaid payments for Evaluation and Management services up 109% to $31,769 in 2024

In 2024, Medicaid providers in Dillsburg submitted $31,769 in claims for Evaluation and Management services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a rise of 108.6% compared with 2023, when such claims totaled $15,229.

Medicaid is operated by the states and funded through a federal-state partnership. The program provides coverage for low-income individuals and families, seniors, children, and people with disabilities, ranking among the largest components of the U.S. health care system.

Given that Medicaid payments depend on taxpayer funding, shifts in how services are billed locally illustrate the allocation of public health care dollars in an area.

The “Evaluation and Management” designation covers a set of Medicaid-billed services determined by care type, classified under standardized HCPCS and CPT code ranges. For this report, each billing code was matched with a single service group using set code prefixes and number ranges so related care types could be grouped together, ensuring accuracy and preventing double-counting as well as keeping reliable rankings year over year.

While increases were recorded across several Medicaid service categories, Evaluation and Management ranked as the leading category by total Medicaid spending in Dillsburg for 2024.

Statewide in Pennsylvania, Evaluation and Management held the fourth spot in total Medicaid payments during 2024.

Looking at the five-year stretch leading up to 2024, Dillsburg’s Medicaid spending for Evaluation and Management services rose by $27,056, marking a 574% increase. Some periods showed sharper year-over-year gains, notably during 2021 and 2022.

Spending for services in the Evaluation and Management category was spread citywide but was most heavily focused in a small number of ZIP codes. In 2024, the highest Medicaid payments for this service type in Dillsburg came from ZIP code 17019, totaling $31,768. Altogether, this ZIP code accounted for 100% of the city’s Medicaid spending in this category that year.

Within the Evaluation and Management group, payments were mainly distributed among a few specific billing codes.

When comparing categories, Medicaid spending for Evaluation and Management in Dillsburg increased by 108.6% between 2024 and 2023, while all Medicaid claim types in the city saw a 210.9% change during that same period.

According to the Centers for Medicare & Medicaid Services, total Medicaid outlays from both federal and state sources reached about $871.7 billion in fiscal 2023, making up roughly 18% of all U.S. health expenditures, up from about $613.5 billion in 2019 prior to the COVID-19 pandemic.

This represents a roughly 40% increase in a few years, primarily linked to broader enrollment and greater utilization throughout and following the pandemic period.

Recent federal budget actions during the Trump administration brought major proposed Medicaid cuts and program changes. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to trim more than $1 trillion from federal Medicaid spending over the next decade. It also implements work requirements and higher cost-sharing, which could restrict coverage and decrease funding for certain participants. These adjustments are projected to shift more costs to the states and hold back federal Medicaid growth even as millions of Americans continue to rely on the program.

Note: HCPCS codes are provided for context within the category. The totals and rankings discussed here use standardized service groups and not individual billing codes.

Data for this article comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Source information is available here.