In 2024, Lehi Medicaid providers submitted $932,754 in claims categorized under Evaluation and Management services, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This sum was 106.3% higher than 2023, when providers billed $452,152 for similar services.
Medicaid is a state-administered public health insurance program, funded collaboratively by federal and state governments. It offers coverage for low-income people and families, older adults, children, and individuals with disabilities, making it a sizable component of the health care landscape in the United States.
Since Medicaid relies on taxpayer funding, shifts in local billing amounts indicate how public resources are spent on health care in each community.
The “Evaluation and Management” classification encompasses a set of Medicaid-billed services, defined according to standardized HCPCS and CPT code groupings. For this report, each billing code was placed into one service category based on consistent prefix and numeric conventions, facilitating analysis of related services while preventing double counting and maintaining consistent category rankings over time.
Even as Medicaid expenditures rose in multiple categories, Evaluation and Management held the second-highest rank for total Medicaid payments in Lehi for 2024.
Statewide in Utah, Evaluation and Management ranked third in terms of Medicaid payments during the same year.
From 2019 through 2024, Medicaid claims in Lehi for Evaluation and Management rose by $730,127, or 360.3%. Particularly strong growth periods occurred in 2021 and 2023, exhibiting notable year-over-year increases.
Although payments for Evaluation and Management care occurred citywide, most were concentrated within just a few ZIP codes. In 2024, ZIP code 84048 had Medicaid payments reaching $760,667, while 84043 accounted for $172,086. Combined, these top two ZIP codes made up the entire Medicaid spending for Evaluation and Management services in Lehi that year.
Most Medicaid payments in this service group were tied to a small selection of specific billing codes.
Medicaid Evaluation and Management billing in Lehi surged 106.3% from 2023 to 2024, compared to just a 1.8% increase for all Medicaid service categories locally during the same span.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid programs spent about $871.7 billion in fiscal year 2023, accounting for close to 18% of national health expenditures. That total was a steep increase from approximately $613.5 billion in 2019, prior to the COVID-19 pandemic.
This national growth—about 40% in a few years—was due mainly to greater enrollment and increased usage during and following the pandemic.
Major Medicaid program changes have been debated under recent federal budget legislation during the Trump administration. The “One Big Beautiful Bill Act,” for instance, became law in 2025 and is expected to trim more than $1 trillion from Medicaid spending over 10 years. It would add measures such as work requirements and higher cost-sharing, which may decrease funding and coverage for some recipients. States are poised to assume a larger cost burden due to these federal funding restraints, though the Medicaid program remains essential for millions across the United States.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $202,627 | 4.9% |
| 2021 | $214,283 | 5.8% |
| 2022 | $216,651 | 1.1% |
| 2023 | $452,152 | 108.7% |
| 2024 | $932,754 | 106.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Anesthesia | $2,874,677 | 64.7% |
| 2 | Evaluation and Management | $932,754 | 21% |
| 3 | Ambulance and Other Transport Services and Supplies | $282,336 | 6.4% |
| 4 | Medicine Services and Procedures | $226,028 | 5.1% |
| 5 | Surgery | $76,944 | 1.7% |
| 6 | Pathology and Laboratory Procedures | $46,788 | 1.1% |
| 7 | Procedures / Professional Services | $1,021 | <0.1% |
| 8 | Radiology Procedures | $358 | <0.1% |
| 9 | Vision Services | $127 | <0.1% |
| 10 | Drugs Administered Other than Oral Method | $41 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99310 | Sbsq nf care high mdm 45 | $400,622 | 14 |
| 99309 | Sbsq nf care moderate mdm 30 | $286,323 | 18 |
| 99214 | Office o/p est mod 30 min | $87,788 | 57 |
| 99306 | 1st nf care high mdm 50 | $32,151 | 12 |
| 99231 | Sbsq hosp ip/obs sf/low 25 | $31,883 | 11 |
| 99497 | Advncd care plan 30 min | $30,996 | 12 |
| 99204 | Office o/p new mod 45 min | $28,332 | 16 |
| 99213 | Office o/p est low 20 min | $22,925 | 20 |
| 99308 | Sbsq nf care low mdm 20 | $6,732 | 11 |
| 99484 | Care mgmt svc bhvl hlth cond | $1,565 | 5 |
| 99305 | 1st nf care moderate mdm 35 | $1,033 | 1 |
| 99490 | Chrnc care mgmt staff 1st 20 | $817 | 3 |
| 99203 | Office o/p new low 30 min | $693 | 1 |
| 99439 | Chrnc care mgmt staf ea addl | $367 | 1 |
| 99140 | Anes comp emergency cond | $169 | 12 |
| 99454 | Rem mntr physiol param 16-30 | $158 | 5 |
| 99100 | Anes pt exteme age70 | $133 | 5 |
| 99406 | Behav chng smoking 3-10 min | $57 | 8 |
| 99458 | Rpm tx mgmt ea addl 20 min | $1 | 5 |
| 99457 | Rpm tx mgmt 1st 20 min | $0 | 5 |
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.
