In 2024, Medicaid providers in Manteca billed a total of $9,499,731 for services under the Evaluation and Management category, as detailed by the U.S. Department of Health and Human Services Medicaid Provider Spending database. That sum represents a 31.5% jump compared to 2023, when the same service type accounted for $7,222,589 in claims.
Medicaid is a joint federal and state health insurance program managed by the states and funded together by both levels of government. The program provides coverage for low-income families and individuals, children, seniors and people with disabilities, making it one of the cornerstone components of the U.S. health care system.
As Medicaid payments are funded by taxpayers, local billing changes reflect how health care resources are distributed in each community.
The “Evaluation and Management” category includes Medicaid-billed services that are grouped according to the nature of care, using standardized HCPCS and CPT code groupings. For this analysis, billing codes were assigned to one service category based on code prefixes and assigned numeric ranges, allowing related services to be tracked together, avoiding double counting and ensuring accurate year-to-year comparisons.
Spending rose across several Medicaid service categories, but Evaluation and Management represented the largest share of Medicaid payments in Manteca in 2024.
Statewide, Evaluation and Management came in second among all service categories by total Medicaid payments in California in 2024.
Between 2019 and 2024, Medicaid payments in Manteca tied to the Evaluation and Management category climbed by $5,013,810, an increase of 111.8%. The rate of growth picked up during certain intervals, with notable yearly increases in 2021 and 2020.
Payments related to Evaluation and Management were spread across the city but were primarily concentrated in a small number of ZIP codes. In 2024, ZIP code 95337 saw $6,806,833 in Medicaid payments, with 95336 at $2,692,897. These two top ZIP codes represented all Medicaid payments associated with Evaluation and Management in Manteca that year.
Within the Evaluation and Management category, most Medicaid payments were focused on a small subset of individual billing codes.
Compared to the 31.5% rise for Evaluation and Management payments between 2024 and 2023, all Medicaid claim categories in Manteca increased by 13.2% for the same period.
Data from the Centers for Medicare & Medicaid Services show that combined federal and state Medicaid expenditures reached about $871.7 billion in fiscal 2023, accounting for approximately 18% of national health spending. That’s up from $613.5 billion in 2019, before the COVID-19 pandemic.
This increase amounts to growth of about 40% in just a few years, largely due to expanded enrollment and greater use of health services during and after the pandemic.
Recent federal budget measures under the Trump administration have included major proposals to trim federal Medicaid funding and change the program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next 10 years. The law also brings in new policies such as work requirements and increased cost-sharing, which could reduce coverage and reduce funding for some beneficiaries, shifting more expenses to states and curbing federal spending growth even as Medicaid serves tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $4,485,921 | 25.2% |
| 2021 | $5,893,209 | 31.4% |
| 2022 | $6,653,945 | 12.9% |
| 2023 | $7,222,589 | 8.5% |
| 2024 | $9,499,730 | 31.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $9,499,730 | 22.8% |
| 2 | National Codes Established for State Medicaid Agencies | $7,869,378 | 18.9% |
| 3 | Drugs Administered Other than Oral Method | $7,575,444 | 18.2% |
| 4 | Pathology and Laboratory Procedures | $3,709,793 | 8.9% |
| 5 | Radiology Procedures | $3,326,305 | 8% |
| 6 | Anesthesia | $3,038,859 | 7.3% |
| 7 | Medicine Services and Procedures | $2,824,526 | 6.8% |
| 8 | Surgery | $1,311,404 | 3.1% |
| 9 | Dental Services | $1,292,833 | 3.1% |
| 10 | Ambulance and Other Transport Services and Supplies | $493,235 | 1.2% |
| 11 | Chemotherapy Drugs | $436,136 | 1% |
| 12 | Diagnostic Radiology Services | $123,148 | 0.3% |
| 13 | Temporary National Codes (Non-Medicare) | $74,751 | 0.2% |
| 14 | Procedures / Professional Services | $66,719 | 0.2% |
| 15 | Temporary Codes | $50,209 | 0.1% |
| 16 | Hearing Services | $18,470 | <0.1% |
| 17 | Administrative, Miscellaneous and Investigational | $10,555 | <0.1% |
| 18 | Medical And Surgical Supplies | $6,926 | <0.1% |
| 19 | Vision Services | $5,675 | <0.1% |
| 20 | Alcohol and Drug Abuse Treatment | $2,048 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99284 | Emergency dept visit mod mdm | $1,824,858 | 107 |
| 99282 | Emergency dept visit sf mdm | $1,659,661 | 12 |
| 99283 | Emergency dept visit low mdm | $1,458,305 | 28 |
| 99285 | Emergency dept visit hi mdm | $1,144,187 | 98 |
| 99214 | Office o/p est mod 30 min | $785,124 | 283 |
| 99213 | Office o/p est low 20 min | $434,055 | 378 |
| 99281 | Emr dpt vst mayx req phy/qhp | $423,401 | 19 |
| 99243 | Off/op cnsltj new/est low 30 | $325,956 | 61 |
| 99204 | Office o/p new mod 45 min | $289,979 | 107 |
| 99242 | Off/op consltj new/est sf 20 | $230,818 | 49 |
| 99232 | Sbsq hosp ip/obs moderate 35 | $193,330 | 25 |
| 99233 | Sbsq hosp ip/obs high 50 | $130,607 | 42 |
| 99244 | Off/op cnsltj new/est mod 40 | $123,290 | 23 |
| 99203 | Office o/p new low 30 min | $97,326 | 89 |
| 99212 | Office o/p est sf 10 min | $77,942 | 147 |
| 99223 | 1st hosp ip/obs high 75 | $58,239 | 37 |
| 99202 | Office o/p new sf 15 min | $57,364 | 29 |
| 99401 | Prev med cnsl indiv apprx 15 | $43,819 | 15 |
| 99215 | Office o/p est hi 40 min | $35,659 | 40 |
| 99291 | Critical care first hour | $15,570 | 9 |
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.
