Utah Medicaid payments for Evaluation and Management services total $113,851,202 in 2024

In 2024, Medicaid payments in Utah for Evaluation and Management services reached $113,851,202, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 5.7% increase from 2023, when providers billed $107,680,254.

Prior-year comparisons in this report are based on the most recent available data from the preceding year.

Medicaid, which is operated by states and funded through a partnership between federal and state governments, insures low-income people and families, children, seniors and individuals with disabilities. It stands as one of the major components of the U.S. health care system.

Fluctuations in Medicaid payment levels highlight how taxpayer-funded resources for public health care are distributed within a community.

The Evaluation and Management category encompasses Medicaid-billed services defined by specific care types, organized with standard HCPCS and CPT code groups. This analysis categorized each payment code to a single service group using established code prefixes and numeric limits, supporting aggregation of similar services for comparison while preventing duplications and sustaining reliable rankings over multiple years.

Some categories include several types of underlying services, capturing related care—such as office visits, diagnostic tests and therapeutic interventions—commonly reflected together under Medicaid billing protocols.

In the five years leading up to 2024, Medicaid payments for the Evaluation and Management category rose by $52,581,325—an 85.8% increase. Certain intervals experienced faster growth, notably in 2021 and 2022 with marked year-to-year rises.

Though Medicaid payments for Evaluation and Management services were made throughout Utah, most funds were concentrated in a few ZIP codes. In 2024, ZIP Code 84113 saw $8,683,352 (7.6% of the state total), ZIP Code 84102 received $7,922,001 (7% of total), and ZIP Code 84604 recorded $7,543,572 (6.6% of total).

The top three ZIP codes together contributed 21.2% of statewide Medicaid payments tied to Evaluation and Management.

For context, Medicaid payments statewide in all service categories grew 1.4% from 2023 to 2024.

Even as Medicaid payments rose in various claim groups, the Evaluation and Management category ranked among Utah’s top three service categories by total Medicaid payments in 2024.

Data from the Centers for Medicare & Medicaid Services shows federal and state Medicaid spending totaled nearly $871.7 billion in fiscal 2023—around 18% of total national health spending—up substantially from $613.5 billion in 2019, before the COVID-19 pandemic.

This represents growth of about 40% over several years, largely due to rising enrollment and greater service utilization surrounding the pandemic period.

Recent federal budget measures under the Trump administration have featured major proposals to curtail federal Medicaid outlays and alter the program framework. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to eliminate more than $1 trillion in federal Medicaid funding over 10 years and introduces items such as work mandates and higher cost-sharing, potentially limiting coverage and funds for portions of the Medicaid population. This could shift more financial responsibility to states and slow the growth in federal Medicaid assistance while still reaching tens of millions of Americans.

Data in this report comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the source here.