Salt Lake City Medicaid Evaluation and Management service costs increase to $42.1 million in 2024

In 2024, providers in Salt Lake City billed Medicaid $42,118,218 for Evaluation and Management services, based on information from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure is up 10.6% from 2023, when the total amount billed for these services was $38,090,607.

Medicaid operates as a state-administered health insurance plan funded collectively by federal and state resources. Serving low-income populations, older adults, children and people with disabilities, Medicaid constitutes a significant segment of the U.S. health care landscape.

Since Medicaid funding is derived from taxpayers, fluctuations in billing at the local level highlight how government health care resources are distributed within each community.

The “Evaluation and Management” grouping includes Medicaid-billed services categorized by care type using set HCPCS and CPT code groupings. Analysts assigned each code to only one service category by using uniform prefixes and defined number ranges, so related services could be studied together, preventing double counting and supporting year-to-year comparisons.

Among the several Medicaid service categories that saw increased spending, Evaluation and Management ranked as the third largest in Salt Lake City for total Medicaid payments in 2024.

Across Utah, this category also placed third statewide by total Medicaid spending in 2024.

Between 2019 and 2024, Salt Lake City Medicaid payments for Evaluation and Management services rose by $22,298,741, marking a 112.5% gain. Certain years, such as 2021 and 2023, saw especially marked annual increases in spending for this category.

Although these services were reimbursed throughout Salt Lake City, payment volume remained concentrated among a small number of ZIP codes. In 2024, ZIP code 84113 posted $8,683,352 in spending, 84102 recorded $7,922,000, and 84132 reported $7,179,110 for Evaluation and Management claims. Altogether, these top 3 ZIP codes made up 56.5% of the city’s total Medicaid payments for this service type in 2024.

A high concentration of Medicaid payments in this category corresponded to only a small group of specific billing codes.

For context, the 10.6% jump in Salt Lake City Evaluation and Management claims from 2023 to 2024 compared with a 2.4% increase across all Medicaid claim types in the city in the same period.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid expenditures reached roughly $871.7 billion for fiscal year 2023, comprising about 18% of overall national health care spending. This rose substantially from $613.5 billion in 2019 before the pandemic.

The nearly 40% rise in spending over this interval is largely linked to rising Medicaid enrollment and expanded service use during and after the pandemic.

Recent federal legislation under the Trump administration introduced efforts to reduce Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut over $1 trillion from federal Medicaid funding over 10 years while instituting measures like work requirements and higher cost-sharing, potentially reducing enrollment and support for some users. The legislation shifts greater expenses to states and could slow growth in federal contributions, despite continued demand for Medicaid across the country.

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.