Port Byron Medicaid Evaluation and Management payments climb 401.3% in 2024

According to the U.S. Department of Health and Human Services Medicaid Provider Spending database, Medicaid providers in Port Byron billed $31,827 for Evaluation and Management services in 2024. This amount reflects a 401.3% jump from the $6,349 submitted by providers for similar services in 2023.

Medicaid, administered by the states and funded through joint federal and state efforts, covers millions of low-income individuals, families, seniors, children, and people with disabilities, making it a significant part of the national health care system.

Because Medicaid funding is taxpayer-based, shifts in local billing patterns highlight where public health resources are utilized in a community.

The “Evaluation and Management” category includes a set of Medicaid-billed services defined by care type, based on specific HCPCS and CPT groupings. For this analysis, each billing code was placed into a distinct service group according to code prefixes and numerical ranges, ensuring related services could be compared over time without duplication and rankings remained accurate.

While Medicaid spending increased in several categories, Evaluation and Management services accounted for the largest share of Medicaid payments in Port Byron in 2024.

Statewide in New York, Evaluation and Management was the second-largest category by overall Medicaid payments in 2024.

Between 2019 and 2024, Medicaid payments in Port Byron linked to Evaluation and Management grew by $6,885, or 17.8%. Growth accelerated at different points, with substantial increases observed in 2021 and 2022.

Although Evaluation and Management spending occurred throughout the city, the majority of Medicaid payments were concentrated in a small number of ZIP codes. In 2024, ZIP code 13140 was responsible for $31,826—comprising 100% of all Medicaid payments for this service category in Port Byron during the year.

The majority of Medicaid spending for Evaluation and Management was associated with a limited selection of billing codes.

Comparing years, Evaluation and Management-related Medicaid payments in Port Byron grew by 401.3% from 2023 to 2024. Across every Medicaid claim category in the city, the overall change for the same period was 10.2%.

Centers for Medicare & Medicaid Services data show that total federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023. This represented about 18% of national health expenditures, a notable increase from $613.5 billion in 2019 before the onset of the COVID-19 pandemic.

This increase translates into about 40% growth over a few years, driven by heightened enrollment and service use during and following the pandemic era.

The Trump administration’s recent federal budget legislation has included major proposals to cut federal Medicaid funding and revise the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next decade. The measure includes policy changes such as work requirements and greater cost-sharing, which could affect access and funding for certain beneficiaries. These shifts are likely to increase responsibilities for states and may limit federal Medicaid growth, as the program continues to serve 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.