Cleveland Medicaid payments for Evaluation and Management services total $252,296 in 2024

According to the U.S. Department of Health and Human Services Medicaid Provider Spending database, Medicaid providers in Cleveland submitted $252,296 in claims for Evaluation and Management services in 2024. This represented a 1.1% uptick from 2023, when total claims for this category amounted to $249,430.

Medicaid is a publicly funded health insurance program managed by state governments and jointly financed by federal and state contributions. It insures low-income people and families, seniors, children, and individuals with disabilities, making it one of the nation’s most substantial health care programs. For more details, see this explainer.

Taxpayer funding drives Medicaid, so shifts in the volume of local billings reflect how a community’s health care dollars are distributed.

The “Evaluation and Management” classification covers Medicaid-reimbursed services defined by standardized HCPCS and CPT code ranges related to the scope of care provided. In this report, billing codes were grouped into service categories with uniform prefixes and numeric intervals, facilitating combined category analysis and preventing double reporting or skewed rankings throughout recent years.

Evaluation and Management ranked as the second-leading Medicaid service category in Cleveland during 2024, despite increases across multiple segments.

Statewide across North Carolina, Evaluation and Management also held the second position for Medicaid payment totals in 2024.

Over the prior five years, Cleveland’s Medicaid billing in the Evaluation and Management category increased by $162,867, amounting to a 182.1% rise. There were several years, including 2021 and 2022, where annual gains accelerated noticeably.

Payment distribution within this category spanned the entire city but was highly concentrated within a few ZIP codes in 2024. Notably, ZIP code 27013 accounted for $239,936 while 27103 totaled $12,359, meaning the top 2 ZIPs together represented 100% of Evaluation and Management Medicaid payments in Cleveland that year.

Within Evaluation and Management, Medicaid spending was centralized around a limited selection of specific codes.

To compare, Evaluation and Management saw a 1.1% increase in local Medicaid spending from 2023 to 2024, while total Medicaid claims in Cleveland for all service categories collectively rose by 17.3% in that same interval.

According to the Centers for Medicare & Medicaid Services, nationwide combined state and federal Medicaid expenditures rose to roughly $871.7 billion in fiscal year 2023, making up about 18% of overall national health costs, a notable increase from around $613.5 billion in 2019 before the COVID-19 pandemic.

This rise amounts to an approximately 40% growth over just a few years, attributed mostly to additional program enrollment and expanding service use during and after the pandemic.

Recent congressional budget legislation signed during the Trump administration has introduced policies designed to slow federal Medicaid spending growth and restructure parts of the program. The “One Big Beautiful Bill Act,” enacted in 2025, projects federal Medicaid spending reductions exceeding $1 trillion for the coming decade, including implementing work requirements and greater cost-sharing. These measures are expected to increase the state-level financial burden and constrain federal Medicaid growth, although the program continues to serve tens of millions in the U.S.

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.