Stockton Medicaid spending on evaluation and management services hits $46 million in 2024

Stockton Medicaid providers billed $45,952,451 for Evaluation and Management services in 2024, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents a 30.6% rise compared with 2023, when $35,182,045 in claims were submitted for the same category of service.

Medicaid is a public health insurance program overseen by the states and funded cooperatively by federal and state governments. The program serves low-income individuals, families, seniors, children, and people with disabilities, making it a core part of the nation’s health care system.

Since Medicaid expenses are covered by taxpayers, shifts in local billing reveal how public health care resources are distributed within communities.

The Evaluation and Management service group includes Medicaid-billed care defined by the nature of the service, structured around HCPCS and CPT code clusters. This analysis organized billing codes into singular service categories using consistent prefixes and number ranges, allowing related services to be tracked together while maintaining accurate rankings and avoiding code duplication.

Evaluation and Management was the second-largest Medicaid service category in Stockton by total payments for 2024, among several categories that saw increased spending.

Statewide in California, Evaluation and Management also ranked second by Medicaid payment totals in 2024.

Between 2019 and 2024, Medicaid spending on Evaluation and Management services in Stockton grew by $32,260,458 or 235.6%. Some years saw notably sharper increases, particularly in 2023 and 2021.

Although Evaluation and Management care payments were distributed citywide, most were concentrated in a small number of ZIP codes. In 2024, the highest payments occurred in ZIP code 95210 with $29,397,969, followed by 95202 at $6,684,748, and 95204 with $5,672,584. These top 3 ZIP codes made up 90.9% of Evaluation and Management Medicaid spending in Stockton that year.

Within Evaluation and Management, a limited set of billing codes accounted for the majority of Medicaid payments.

Comparatively, Evaluation and Management Medicaid spending in Stockton rose by 30.6% between 2023 and 2024, while all Medicaid claim categories in the city saw a 10.8% increase during the same span.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures totaled approximately $871.7 billion in fiscal 2023, or about 18% of overall national health spending. That is up from about $613.5 billion in 2019, just before the pandemic.

This growth—about 40% over a handful of years—was fueled mainly by broader enrollment and greater service use during and after the COVID-19 emergency.

Recent national budget law under the Trump administration included major proposals to reduce federal Medicaid financing and alter the program. The “One Big Beautiful Bill Act,” which became law in 2025, is expected to cut more than $1 trillion in federal Medicaid spending over 10 years and adds policies such as work requirements and higher cost-sharing, which could lead to reduced coverage and funding for some individuals. These adjustments are likely to place more costs on states and slow future federal Medicaid growth, even as the program continues serving tens of millions nationwide.

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.