Stockton Medicaid providers report $46 million in evaluation and management service payments for 2024

In 2024, Medicaid providers in Stockton submitted $45,952,451 in claims for Evaluation and Management services, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a 30.6% rise from 2023, when providers billed $35,182,045 for these services.

Medicaid, a public insurance program operated by the states and funded through federal and state sources, serves low-income families and individuals, seniors, children, and people with disabilities. The program is one of the primary components of the U.S. health care system.

As Medicaid funding is taxpayer-supported, shifts in local billing amounts indicate how community health care resources are distributed.

The Evaluation and Management category includes a selection of Medicaid-billed services, determined by the type of medical care provided and categorized using standardized HCPCS and CPT code groupings. This analysis assigned each billing code to a single service group based on consistent code prefixes and numbers to group related services, prevent overlap, and maintain reporting accuracy over time.

Evaluation and Management ranked as the second-largest Medicaid payment category in Stockton for 2024, amid increases across several service types.

Statewide in California, Evaluation and Management also placed second for total Medicaid spending during 2024.

Over the five-year span ending in 2024, Evaluation and Management Medicaid payments in Stockton grew by $32,260,458, or 235.6%. Payment increases were especially significant in certain years, including noteworthy gains in 2023 and 2021.

Spending on Evaluation and Management services was spread citywide but was concentrated in a few ZIP codes. The leading ZIP codes by payment totals in 2024 were 95210 with $29,397,969, 95202 with $6,684,748, and 95204 with $5,672,584. These three ZIP codes accounted for 90.9% of related Medicaid payments in Stockton that year.

Within this service category, a small set of billing codes represented the bulk of Medicaid payments.

For further context, Stockton’s Medicaid payments for Evaluation and Management rose 30.6% between 2024 and 2023, whereas all Medicaid claim categories in the city increased by 10.8% during the same time frame.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending reached roughly $871.7 billion in fiscal year 2023, making up about 18% of the nation’s total health spending. This was a significant jump from approximately $613.5 billion in 2019, prior to the COVID-19 pandemic.

This marks an estimated 40% increase in only a few years, much of it attributed to greater enrollment and usage during and after the pandemic.

Federal budget legislation under the Trump administration has brought forward major proposals aiming to trim federal Medicaid expenditures and make structural changes to the program. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to reduce federal Medicaid spending by over $1 trillion in the next decade and introduces measures such as work requirements and higher cost-sharing. These policies could decrease coverage for some recipients and shift more financial responsibility to states, potentially restricting federal Medicaid growth even as the program continues to serve millions nationwide.

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.