According to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database, Medicaid providers in Draper billed $610,207 for services within the Evaluation and Management category in 2024. This represents a 50.4% increase over 2023, when $405,683 in claims were submitted for the same category of service.
Medicaid, a public health insurance program managed by states and funded in partnership by the federal and state governments, provides coverage for low-income residents, seniors, children and those with disabilities, making it one of the largest components of the American health care landscape.
Taxpayer money funds Medicaid reimbursements, so changes in community billing patterns track how health care funds are allocated locally.
The “Evaluation and Management” service grouping identifies Medicaid-billed care using standardized HCPCS and CPT code categories. For this report, each billing code was assigned a unique service group based on code prefixes and number ranges, helping prevent double counting and upholding category comparison and ranking accuracy through time.
While Medicaid disbursements increased across several groupings, Evaluation and Management ranked fourth by total Medicaid payments in Draper for 2024.
Statewide in Utah, Evaluation and Management was third among all Medicaid categories by payments that year.
From 2019 through 2024, Draper’s Medicaid payments in this category rose $18,495, an increase of 3.1%. Some years saw faster growth, with significant increases specifically in 2021 and 2022.
Although payments for Evaluation and Management care spanned the city, the majority of funds went to just a few ZIP codes. For 2024, ZIP code 84020 accounted for the entire $610,207 in Medicaid payments associated with this category. In sum, Draper’s top 1 ZIP code represented 100% of Medicaid payments for Evaluation and Management in 2024.
Most Medicaid spending within the Evaluation and Management group was restricted to a limited number of billing codes.
Comparatively, the 50.4% jump in Draper’s Evaluation and Management Medicaid category between 2024 and 2023 far outpaced the 4.7% increase seen across all Medicaid billing categories locally for the same period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures together reached approximately $871.7 billion in fiscal year 2023, or about 18% of all U.S. health spending—a sharp increase from roughly $613.5 billion in 2019, before the COVID-19 pandemic began.
This rise represents about 40% overall growth within several years, primarily fueled by expanded coverage and higher care utilization during and after the pandemic years.
Recent federal budget actions under the Trump administration brought sizable proposals to cut federal Medicaid support and revise program structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years. It enacts measures such as introducing work requirements and raising cost-sharing, which could curtail both federal funding and beneficiary coverage, shifting more expense to state governments even as Medicaid remains a vital source of health coverage for millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $591,712 | -8.6% |
| 2021 | $768,044 | 29.8% |
| 2022 | $847,300 | 10.3% |
| 2023 | $405,682 | -52.1% |
| 2024 | $610,207 | 50.4% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Pathology and Laboratory Procedures | $3,854,895 | 37.4% |
| 2 | National Codes Established for State Medicaid Agencies | $2,973,788 | 28.8% |
| 3 | Procedures / Professional Services | $2,637,390 | 25.6% |
| 4 | Evaluation and Management | $610,207 | 5.9% |
| 5 | Ambulance and Other Transport Services and Supplies | $64,576 | 0.6% |
| 6 | Medicine Services and Procedures | $61,788 | 0.6% |
| 7 | Diagnostic Radiology Services | $49,761 | 0.5% |
| 8 | Temporary Codes | $23,793 | 0.2% |
| 9 | Radiology Procedures | $19,665 | 0.2% |
| 10 | Dental Services | $14,447 | 0.1% |
| 11 | Surgery | $1,687 | <0.1% |
| 12 | Drugs Administered Other than Oral Method | $1,041 | <0.1% |
| 13 | Pathology and Laboratory Services | $30 | <0.1% |
| 14 | Hearing Services | $0 | <0.1% |
| 14 | Temporary National Codes (Non-Medicare) | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $244,027 | 74 |
| 99309 | Sbsq nf care moderate mdm 30 | $141,271 | 12 |
| 99213 | Office o/p est low 20 min | $79,618 | 34 |
| 99204 | Office o/p new mod 45 min | $51,187 | 15 |
| 99203 | Office o/p new low 30 min | $28,216 | 13 |
| 99310 | Sbsq nf care high mdm 45 | $23,074 | 9 |
| 99391 | Per pm reeval est pat infant | $13,530 | 11 |
| 99484 | Care mgmt svc bhvl hlth cond | $7,124 | 10 |
| 99452 | Ntrprof ph1/ntrnet/ehr rfrl | $4,610 | 10 |
| 99306 | 1st nf care high mdm 50 | $4,478 | 3 |
| 99392 | Prev visit est age 1-4 | $3,525 | 10 |
| 99342 | Home/res vst new low mdm 30 | $3,120 | 3 |
| 99308 | Sbsq nf care low mdm 20 | $1,976 | 4 |
| 99393 | Prev visit est age 5-11 | $1,774 | 6 |
| 99451 | Ntrprof ph1/ntrnet/ehr 5/> | $1,052 | 10 |
| 99212 | Office o/p est sf 10 min | $881 | 2 |
| 99483 | Assmt & care pln pt cog imp | $390 | 1 |
| 99000 | Specimen handling office-lab | $262 | 9 |
| 99394 | Prev visit est age 12-17 | $84 | 2 |
| 99173 | Visual acuity screen | $0 | 8 |
Note: HCPCS codes are included for general information within the evaluated category. Data groupings and rankings in this article use standardized category definitions instead of single billing codes.
The information reported in this article originates from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the source data here.
