Rushville Medicaid spending for Evaluation and Management services climbs to $903,821 in 2024

In 2024, Medicaid providers in Rushville billed a total of $903,821 for services in the Evaluation and Management category, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 79.7% rise from 2023, when billing for these services totaled $502,930.

Medicaid is a government health insurance program operated by individual states and financed cooperatively by federal and state governments. The program serves low-income residents, seniors, children, and individuals with disabilities, making it one of the nation’s primary health care systems.

Since Medicaid dollars are drawn from public funds, local billing changes highlight how health care resources are distributed within a community.

The “Evaluation and Management” classification encompasses a variety of services billed to Medicaid, defined by the nature of care provided and standardized by HCPCS and CPT code groupings. For this report, billing codes were assigned to one service category using consistent code prefixes and numeric ranges, allowing for aggregate analysis of related services while avoiding double counting and ensuring accuracy in year-to-year rankings.

While Medicaid expenses increased in several service categories, Evaluation and Management was the leading category in Rushville in terms of Medicaid payments for 2024.

Statewide in New York, the Evaluation and Management category was second overall by payment total for 2024.

Medicaid payments designated for the Evaluation and Management category in Rushville rose by $472,909, or 109.7%, during the five years preceding 2024. Certain years saw especially strong increases, notably in 2021 and 2023.

Although expenditures for Evaluation and Management services were spread across Rushville, payments were heavily centered in a small group of ZIP codes. In 2024, ZIP code 14544 accounted for $903,820 in Medicaid payments in this category, meaning the top 1 ZIP code made up 100% of Evaluation and Management Medicaid spending in Rushville for the year.

Inside the Evaluation and Management category, Medicaid spending was concentrated within a limited set of individual billing codes.

Comparatively, between 2024 and 2023, Medicaid spending in the Evaluation and Management category increased 79.7% in Rushville, versus a 31% shift across all Medicaid service categories in the city over the same timeframe.

According to the Centers for Medicare & Medicaid Services, the combined federal and state Medicaid expenditures rose to approximately $871.7 billion in fiscal year 2023, making up around 18% of total U.S. health spending, an increase from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This growth represents an increase of about 40% over several years, largely attributed to broader enrollment and greater utilization during and following the pandemic.

Recent federal budget measures enacted during the Trump administration have proposed substantial reductions to federal Medicaid funding and changes to program structure. The “One Big Beautiful Bill Act,” signed into law in 2025, is estimated to reduce federal Medicaid spending by more than $1 trillion over the next 10 years, enacting provisions such as work requirements and greater cost-sharing that may impact coverage and funding for some recipients. These shifts are expected to place more financial responsibility on states and curb federal Medicaid support as the program continues to provide coverage for tens of millions of Americans.

Note: HCPCS codes are provided for reference within the category. Totals and rankings in this report are determined by standardized groupings, not individual billing codes.

Information for this report was sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data is available here.