Gridley Medicaid providers reported billing $2,004,916 for Evaluation and Management services in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure marked a 55.2% rise compared with 2023, which saw $1,291,639 in claims for this service category.
Medicaid is a publicly funded health insurance program managed by states and financed by both federal and state governments. It provides coverage for low-income individuals and families, as well as seniors, children, and people with disabilities, making it one of the largest components of the U.S. health care system.
As Medicaid funding is sourced from taxpayers, variations in billing at the local level reflect how public health care resources are distributed within a community.
The “Evaluation and Management” category represents a group of services billed to Medicaid based on the care delivered, organized through standardized HCPCS and CPT coding. For report purposes, each billing code is assigned to a single service category using established code ranges and prefixes, enabling a detailed view of related services and accurate year-over-year comparisons without duplication.
Evaluation and Management became the leading category for total Medicaid payments in Gridley for 2024, outpacing all other service types.
Statewide in California for 2024, this category ranked second by total Medicaid payment volume.
During the five years prior to 2024, Medicaid payments for Evaluation and Management in Gridley increased by $1,558,265, or 348.9%. Certain periods, including 2023 and 2021, saw pronounced year-over-year growth.
Even though Evaluation and Management care payments were spread throughout the city, most Medicaid payments within this category were concentrated in a small number of ZIP codes. In 2024, ZIP code 95948 accounted for $2,004,916—the highest amount—making up 100% of Medicaid payments for the category in Gridley for the year.
A small subset of billing codes dominated Medicaid payments within the Evaluation and Management category.
From 2023 to 2024, payments linked to Evaluation and Management in Gridley jumped 55.2%, while all Medicaid claim categories within the city saw a 16.4% increase during the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures climbed to approximately $871.7 billion during fiscal year 2023, accounting for around 18% of all national health outlays—a significant increase from nearly $613.5 billion in 2019, before the COVID-19 pandemic.
This growth reflects an increase of roughly 40% in a few years, largely fueled by broader enrollment and rises in use both during and after the pandemic.
Recent federal legislation enacted under the Trump administration has included major measures aimed at reducing Medicaid’s federal funding and restructuring how the program operates. The “One Big Beautiful Bill Act,” passed in 2025, is projected to lower federal Medicaid spending by more than $1 trillion over the upcoming decade while introducing such policies as work requirements and stepped-up cost-sharing. These reforms are anticipated to shift additional costs to states and moderate the rate of increase in federal Medicaid support, even as the program continues to aid tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $446,650 | -5% |
| 2021 | $635,084 | 42.2% |
| 2022 | $787,575 | 24% |
| 2023 | $1,291,638 | 64% |
| 2024 | $2,004,916 | 55.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $2,004,916 | 34.4% |
| 2 | National Codes Established for State Medicaid Agencies | $1,202,345 | 20.6% |
| 3 | Radiology Procedures | $931,466 | 16% |
| 4 | Medicine Services and Procedures | $841,402 | 14.4% |
| 5 | Procedures / Professional Services | $316,503 | 5.4% |
| 6 | Alcohol and Drug Abuse Treatment | $288,581 | 4.9% |
| 7 | Pathology and Laboratory Procedures | $233,828 | 4% |
| 8 | Drugs Administered Other than Oral Method | $13,325 | 0.2% |
| 9 | Anesthesia | $885 | <0.1% |
| 10 | Temporary Codes | $223 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99281 | Emr dpt vst mayx req phy/qhp | $659,181 | 11 |
| 99484 | Care mgmt svc bhvl hlth cond | $415,094 | 9 |
| 99284 | Emergency dept visit mod mdm | $257,953 | 4 |
| 99213 | Office o/p est low 20 min | $154,830 | 48 |
| 99215 | Office o/p est hi 40 min | $148,555 | 8 |
| 99283 | Emergency dept visit low mdm | $148,441 | 6 |
| 99214 | Office o/p est mod 30 min | $111,298 | 28 |
| 99070 | Special supplies phys/qhp | $31,421 | 9 |
| 99203 | Office o/p new low 30 min | $29,321 | 18 |
| 99285 | Emergency dept visit hi mdm | $16,435 | 2 |
| 99282 | Emergency dept visit sf mdm | $10,910 | 2 |
| 99212 | Office o/p est sf 10 min | $6,111 | 25 |
| 99204 | Office o/p new mod 45 min | $5,787 | 6 |
| 98941 | Chiropract manj 3-4 regions | $2,357 | 5 |
| 99202 | Office o/p new sf 15 min | $2,133 | 3 |
| 99396 | Prev visit est age 40-64 | $2,103 | 10 |
| 98940 | Chiropract manj 1-2 regions | $1,404 | 3 |
| 99392 | Prev visit est age 1-4 | $1,046 | 2 |
| 99393 | Prev visit est age 5-11 | $526 | 1 |
| 99395 | Prev visit est age 18-39 | $0 | 1 |
Note: HCPCS codes are provided for context within the category. Service groupings, not individual codes, determine category totals and rankings referenced in this article.
Details for this article were sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database, accessible here.
