In 2024, Medicaid providers in San Jon billed $3,033 for Evaluation and Management category services, U.S. Department of Health and Human Services Medicaid Provider Spending database data shows. This was up 93.1% from 2023, when claims for these services totaled $1,571.
Medicaid is a government-run public health insurance plan operated by individual states and funded through a partnership between federal and state governments. The program insures low-income individuals and families, seniors, children and people with disabilities, and constitutes a major part of the U.S. health care landscape.
Since Medicaid payments draw from taxpayer funds, shifts in local billing amounts reflect how public health care spending is distributed in a given area.
The Evaluation and Management category includes a set of Medicaid services grouped by care type, defined using standardized HCPCS and CPT code groupings. Billing codes were sorted into specific service categories by applying consistent code prefixes and numeric ranges, ensuring related services are reported together, double counting is avoided and comparability over time is maintained.
San Jon saw Evaluation and Management services top all Medicaid service categories by total payment volume in 2024, despite increases in a range of service categories.
Statewide in New Mexico, Evaluation and Management services held the third spot for total Medicaid payments in 2024.
Between 2019 and 2024, San Jon’s Medicaid spending on Evaluation and Management remained flat at $3,033, for an increase of 0%. Certain periods featured faster growth, with significant annual jumps reported in both 2022 and 2022.
Spending on Evaluation and Management services was geographically distributed, but a small set of ZIP codes accounted for the bulk of payments. In 2024, ZIP code 88434 saw the highest Medicaid payments for this category, at $3,032. That year, the top ZIP code comprised 100% of San Jon’s Medicaid spending on these services.
Payments tied to Evaluation and Management were also concentrated in a select group of billing codes within the category.
Comparatively, Medicaid payments for this category in San Jon rose 93.1% from 2023 to 2024, similar to the 93% overall increase across all Medicaid claim groups in the city.
According to the Centers for Medicare & Medicaid Services, total Medicaid spending topped about $871.7 billion in fiscal 2023, representing approximately 18% of total national health spending—up from roughly $613.5 billion in 2019 before the COVID-19 pandemic.
This marks nearly 40% growth over several years, mainly attributed to broader enrollment and heightened use of services through and after the pandemic.
Recent federal budget packages under the Trump administration have proposed major reductions to federal Medicaid funding and other reforms. The “One Big Beautiful Bill Act,” signed in 2025, is set to cut more than $1 trillion from federal Medicaid spending over 10 years, adding work requirements and higher cost-sharing that could affect some beneficiaries’ coverage or funding. These changes are likely to shift more financial responsibility onto states while limiting the pace of federal Medicaid funding increases, even as the program continues to provide for tens of millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2021 | $1,969 | – |
| 2022 | $2,232 | 13.3% |
| 2023 | $1,571 | -29.6% |
| 2024 | $3,032 | 93% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $3,032 | 10<0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $3,032 | 2 |
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.
