In 2024, Medicaid providers in Stewartstown billed $19,418 for Evaluation and Management services, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This figure represents a 68.6% rise compared to 2023, when $11,520 was submitted for the same service category.
Medicaid, administered by the states and funded in partnership between federal and state governments, provides healthcare coverage for low-income families, seniors, children, and people with disabilities, and is one of the largest U.S. health care programs.
Because taxpayer contributions fund Medicaid, fluctuations in community billing track how public health care expenditures are distributed locally.
The “Evaluation and Management” category includes groups of services Medicaid bills as defined by care type, using standardized HCPCS and CPT code groupings. Each billing code is assigned to a single category for this analysis, relying on consistent code prefixes and numeric ranges to combine related services, avoid double counting, and keep historic rankings accurate.
Evaluation and Management services topped all Medicaid payment categories in Stewartstown for total Medicaid spending in 2024.
Statewide, Evaluation and Management held the fourth position among Pennsylvania Medicaid spending categories in 2024.
From 2020 to 2024, Stewartstown Medicaid payments for Evaluation and Management totaled $19,418, showing 0% growth over five years. Notable increases were seen in 2023 and 2022 as growth accelerated during certain periods.
Spending for Evaluation and Management care in Stewartstown was not evenly distributed, with most payments coming from a select group of ZIP codes. In 2024, ZIP code 17363 made up $19,418 of the total, representing 100% of the city’s Medicaid payments for this category.
Within Evaluation and Management, most Medicaid payments were tied to a small set of individual billing codes.
Comparatively, Stewartstown’s Medicaid payments for Evaluation and Management rose 68.6% from 2023 to 2024, while the city’s total Medicaid claim value across all categories shifted by 14.2% within the same period.
Centers for Medicare & Medicaid Services data indicates combined federal and state Medicaid outlays reached about $871.7 billion in fiscal year 2023, or 18% of the nation’s health expenditure total, a significant jump from $613.5 billion in 2019 prior to COVID-19.
This growth amounts to roughly 40% over several years, largely fueled by increased enrollment and higher service use during and after the pandemic.
Recent federal budget measures enacted under the Trump administration introduced major proposals slashing federal Medicaid funding and restructuring the program. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is forecast to cut federal Medicaid outlays by more than $1 trillion over 10 years, with policies including work requirements and increased cost sharing that could lessen coverage and support for some. These reforms are expected to transfer more financial burden to states and limit federal Medicaid growth, even as millions rely on the program.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2023 | $11,520 | – |
| 2024 | $19,418 | 68.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $19,418 | 10<0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $15,708 | 16 |
| 99213 | Office o/p est low 20 min | $3,709 | 7 |
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.
