Lathrop Medicaid Evaluation and Management payments rise to $66,624 in 2024

Lathrop Medicaid providers billed $66,624 for Evaluation and Management services in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This represented a 188.3% increase compared to 2023, when providers submitted $23,109 in claims for these services.

Medicaid, a health insurance program operated by the states and co-funded by federal and state sources, insures low-income groups including families, seniors, children, and people with disabilities. As such, Medicaid represents a major part of the U.S. health care landscape. Further general background may be found here.

Taxpayer funds support Medicaid payments, so fluctuations in local billing levels reveal how public health care resources are distributed within communities.

The Evaluation and Management category encompasses a defined set of billed services, structured by the type of clinical care following HCPCS and CPT code guidelines. Each billing code was classified into a single service category by standardized prefixes and numeric ranges, ensuring related services are combined and accurately ranked historically, without duplication.

Increases in Medicaid expenditures were observed in several service categories, but in 2024, Evaluation and Management led all other categories by total Medicaid reimbursements in Lathrop.

Across California as a whole, Evaluation and Management ranked No. 2 statewide for total Medicaid payments in 2024.

Between 2019 and 2024, Medicaid payments for the Evaluation and Management group in Lathrop grew by $62,328, an increase of 1451%. Growth rates accelerated during certain intervals, with significant annual rises noted in 2022 and 2020.

Although funds for Evaluation and Management were distributed citywide, spending was concentrated in a handful of ZIP codes. In 2024, ZIP code 95330 accounted for all Medicaid Evaluation and Management payments, totaling $66,624 and representing 100% of category payments in Lathrop.

Claims within this category were additionally focused among a small cluster of individual billing codes.

Looking at changes by category, local Medicaid spending on Evaluation and Management in Lathrop was up 188.3% between 2024 and 2023, while the combined increase for all Medicaid claims in the city during that period reached 213.7%.

Centers for Medicare & Medicaid Services data show that total federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023, making up around 18% of all national health spending. This figure rose sharply compared to about $613.5 billion in 2019, reflecting pandemic-driven trends.

This increase equals a roughly 40% rise over just a few years, mostly fueled by expanded Medicaid enrollment and increased use of services throughout and after the COVID-19 pandemic.

Recent federal budget measures from the Trump administration included proposals to reduce federal Medicaid funding and reformat the program. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid spending by more than $1 trillion across the next decade. The bill also created new requirements, such as work obligations and higher cost-sharing, that may lower coverage and spending for certain recipients. These adjustments are projected to shift more financial responsibility to states and limit federal Medicaid growth, while the program continues to support tens of millions.

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.