Medicaid Evaluation and Management payments in Mill Creek reach $509 in 2024, up 283% from prior year

In 2024, Medicaid providers in Mill Creek billed a total of $509 for Evaluation and Management services, as reported by the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 282.7% jump from 2023, when providers submitted $133 in claims for the same type of care.

Medicaid, a joint state and federally funded health insurance program, covers low-income families and individuals, seniors, children, and people with disabilities, positioning it among the largest components of the U.S. health care system. More information about Medicaid’s funding structure is available from the Commonwealth Fund.

Because Medicaid is funded by taxpayer resources, changes in local billing patterns illustrate how public healthcare funding is distributed throughout a community.

The Evaluation and Management category includes a range of Medicaid services, grouped by the kind of care rendered and identified using standard HCPCS and CPT codes. This analysis assigned each billing code to a single service category based on established code prefixes and numeric areas to ensure service groupings were not duplicated, allowing accurate longitudinal ranking.

While Medicaid spending grew across different service classifications, Evaluation and Management was the second highest by total Medicaid payments in Mill Creek during 2024.

Statewide in West Virginia, Evaluation and Management also held the number two spot for total Medicaid payments in 2024.

Over the previous five years, Medicaid funding for Evaluation and Management services in Mill Creek climbed by $226, equating to a 30.7% rise. During that period, certain years such as 2021 and 2023 saw more significant gains in year-over-year spending.

Spending within this category was distributed across Mill Creek but concentrated in select ZIP codes. In 2024, ZIP code 26280 accounted for $508 of these Medicaid payments, meaning a single ZIP code represented 100% of all Medicaid spending for Evaluation and Management services in Mill Creek that year.

Payments within the Evaluation and Management category were also focused among a small set of individual billing codes.

For further comparison, Medicaid spending on Evaluation and Management services in Mill Creek grew 282.7% between 2024 and 2023, while spending across all claim categories increased just 0.7% locally during the same timeframe.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal 2023. That amounted to about 18% of all U.S. health spending, a substantial rise from $613.5 billion in 2019, just before the COVID-19 pandemic.

This surge represents roughly 40% growth over several years, fueled mainly by expanded enrollments and increased service use around the pandemic.

Major federal budget measures during the Trump administration contained large-scale proposals to curb Medicaid expenditures and alter the program’s structure. The “One Big Beautiful Bill Act,” which became law in 2025, is projected to slash more than $1 trillion in federal Medicaid payments over the coming decade and to bring new requirements for work and cost-sharing. These changes could reduce coverage and funding for some recipients, shifting increased costs to states while restricting future growth in federal Medicaid funding, though the program continues to reach tens of millions of Americans.

Note: HCPCS codes are presented to show the makeup of the category. Category totals and rankings referenced here are based on consistent service groupings, not individual codes.

Data for this story was sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. You can view the source information here.