In Sandy, Medicaid providers billed $1,170,403 for Evaluation and Management services in 2024, using the U.S. Department of Health and Human Services Medicaid Provider Spending database as reference. This was up 28.1% compared to 2023, when claims for the same services totaled $913,771.
Medicaid is a government insurance program operated by the states and funded in partnership by federal and state governments. It provides coverage for low-income people, seniors, children and those with disabilities, making it a core component of the U.S. health system.
As Medicaid payments are sourced from tax funds, local billing fluctuations reflect how public health care resources are distributed in each community.
The “Evaluation and Management” group represents Medicaid services classified by care type, according to standardized groupings of HCPCS and CPT codes. Each billing code in this analysis was placed in a single service category through set code prefixes and number ranges, enabling consistent comparisons of related services, reducing the risk of overlap and ensuring accuracy in rankings over time.
Even though Medicaid spending increased in several categories, Evaluation and Management was third in Sandy for total Medicaid payments in 2024.
Across Utah, the Evaluation and Management group was also third in the state in 2024 for total Medicaid payments.
Looking at the five years prior to 2024, Sandy’s Medicaid payments tied to Evaluation and Management services rose by $1,008,609 or 623.4%. Increases were especially notable in specific years, with major annual jumps reported in 2021 and 2023.
Though spending on Evaluation and Management occurred throughout Sandy, it was clustered within a small group of ZIP codes in 2024: 84070 generated $610,475, 84094 totaled $540,928, and 84093 logged $11,289. Together, these top 3 ZIP codes accounted for 99.3% of Medicaid payments to Evaluation and Management services citywide.
Payments in the Evaluation and Management group were further dominated by just a handful of individual billing codes.
In comparison, Evaluation and Management Medicaid payments in Sandy grew by 28.1% between 2024 and 2023, while all Medicaid claim categories in the city saw a combined 25.3% increase during that period.
According to the Centers for Medicare & Medicaid Services, nationwide Medicaid spending from federal and state sources reached approximately $871.7 billion in fiscal year 2023, about 18% of total national health expenditures, a significant jump from $613.5 billion in 2019 preceding the COVID-19 pandemic.
This growth translates to roughly 40% over just a few years, largely attributed to higher enrollment and increased use during and following the pandemic.
Federal budget measures adopted during the Trump administration include major efforts to cut federal Medicaid funding and change how the program works. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years and brings in policies such as work requirements and greater cost-sharing, with potential impacts on beneficiary coverage and funding. These changes are predicted to increase states’ financial responsibility and limit future federal Medicaid support, even as the program remains vital to tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $161,794 | -17% |
| 2021 | $508,180 | 214.1% |
| 2022 | $657,921 | 29.5% |
| 2023 | $913,771 | 38.9% |
| 2024 | $1,170,402 | 28.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $4,611,697 | 44.7% |
| 2 | Medicine Services and Procedures | $2,987,529 | 29% |
| 3 | Evaluation and Management | $1,170,402 | 11.4% |
| 4 | Ambulance and Other Transport Services and Supplies | $613,692 | 6% |
| 5 | Alcohol and Drug Abuse Treatment | $461,378 | 4.5% |
| 6 | Medical And Surgical Supplies | $365,974 | 3.5% |
| 7 | Surgery | $34,261 | 0.3% |
| 8 | Hearing Services | $32,326 | 0.3% |
| 9 | Durable Medical Equipment | $16,507 | 0.2% |
| 10 | Dental Services | $9,021 | 0.1% |
| 11 | Pathology and Laboratory Procedures | $6,539 | 0.1% |
| 12 | Procedures / Professional Services | $234 | <0.1% |
| 13 | Diagnostic Radiology Services | $4 | <0.1% |
| 14 | Temporary Codes | $2 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $570,778 | 105 |
| 99215 | Office o/p est hi 40 min | $190,549 | 23 |
| 99213 | Office o/p est low 20 min | $110,186 | 49 |
| 99211 | Off/op est may x req phy/qhp | $83,970 | 12 |
| 99417 | Prolng op e/m each 15 min | $65,765 | 11 |
| 99205 | Office o/p new hi 60 min | $46,029 | 11 |
| 99391 | Per pm reeval est pat infant | $19,575 | 11 |
| 99308 | Sbsq nf care low mdm 20 | $19,282 | 12 |
| 99393 | Prev visit est age 5-11 | $17,384 | 11 |
| 99204 | Office o/p new mod 45 min | $17,043 | 15 |
| 99394 | Prev visit est age 12-17 | $13,304 | 11 |
| 99392 | Prev visit est age 1-4 | $10,012 | 11 |
| 99203 | Office o/p new low 30 min | $4,880 | 6 |
| 99490 | Chrnc care mgmt staff 1st 20 | $1,563 | 2 |
| 99188 | App topical fluoride varnish | $71 | 3 |
| 99177 | Ocular instrumnt screen bil | $5 | 6 |
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.
