Salt Lake City Medicaid spending on Evaluation and Management services rises to $42.1 million in 2024

Providers participating in Medicaid in Salt Lake City generated $42,118,218 in claims under the Evaluation and Management category for 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. That figure represents a 10.6% increase over the $38,090,607 in Medicaid claims submitted the previous year for the same category.

Medicaid operates as a public health insurance initiative, managed at the state level and financed by federal and state government contributions. It provides coverage for people with low incomes, older adults, children, and those with disabilities, making it a significant component of the U.S. health care landscape.

Shifts in the billing volume for Medicaid, funded by taxpayers, shed light on how publicly supported health care resources are distributed across local areas.

The Evaluation and Management category encompasses a set of Medicaid-billed services defined by the nature of care, established through standard HCPCS and CPT code groupings. In this analysis, each billing code was attributed to a single service grouping using specific code prefixes and ranges, allowing service trends to be analyzed while preventing duplication and supporting clear rankings over time.

Spending through Medicaid rose in several service categories, but Evaluation and Management was the third-highest in Salt Lake City for 2024 in total payments.

For all of Utah, the Evaluation and Management category was also the third largest by Medicaid payments that year.

From five years prior to 2024, Medicaid spending tied to Evaluation and Management in Salt Lake City increased by $22,298,741, a rise of 112.5%. Key years of accelerated growth included 2021 and 2023, which saw substantial annual increases.

Though funding for Evaluation and Management services spread across the city, payments were concentrated within specific ZIP codes. In 2024, ZIP code 84113 led with $8,683,352 in these payments, followed by 84102 with $7,922,000, and 84132 with $7,179,110. Altogether, these three ZIP codes made up 56.5% of all Medicaid Evaluation and Management expenditures in Salt Lake City that year.

Payments for Evaluation and Management services were also heavily weighted toward a small set of individual billing codes within the category.

Looking at broader trends, Salt Lake City’s Medicaid payments related to Evaluation and Management rose 10.6% from 2023 to 2024, while all Medicaid categories in the city experienced a 2.4% change during that period.

The Centers for Medicare & Medicaid Services reports that nationwide combined federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023. This represented about 18% of national health expenses, up from $613.5 billion in 2019 before the COVID-19 pandemic.

This increase reflects nearly 40% growth over several years, mainly attributed to higher enrollments and usage patterns influenced by the pandemic.

Recent federal budget acts during the Trump administration have proposed substantial reductions to federal Medicaid funding and project shifts in program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut over $1 trillion in federal Medicaid funding across the next decade and introduces new requirements, such as work mandates and larger cost-sharing, likely impacting both coverage and available funding for certain groups. These changes may prompt increased responsibilities for states as federal support slows, though Medicaid remains a core component of health coverage for tens of millions of Americans.

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.