Bloomington sees $550,548 in Medicaid payments for Evaluation and Management services in 2024

In 2024, Medicaid providers in Bloomington reported $550,548 in billings for Evaluation and Management services, according to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 33.5% rise from 2023, when these providers reported $412,487 in claims for the same services.

Medicaid is a government health insurance program managed by the states and funded jointly by state and federal governments. It provides coverage for low-income individuals and families, children, seniors, and people with disabilities, making it one of the largest segments of the U.S. health care landscape.

Since Medicaid expenditures are taxpayer-funded, fluctuations in local billing point to how community health care funding is distributed.

The “Evaluation and Management” category includes Medicaid services identified by type of care provided, classified based on standard HCPCS and CPT code groupings. For this report, each billing code was included under a single service category using code prefixes and numeric ranges to ensure related services are combined without duplication and rankings remain precise over time.

While Medicaid spending increased in several service categories, Evaluation and Management was the second-highest in total Medicaid payments in Bloomington for 2024.

This category also placed second in terms of statewide Medicaid payments in California in 2024.

Between 2019 and 2024, Medicaid payments for Evaluation and Management services in Bloomington rose $353,579, which is a 179.5% increase. Growth in this spending category accelerated in some periods, with substantial year-over-year upticks noted in 2021 and 2023.

Spending for Evaluation and Management services in Bloomington was concentrated in a small number of ZIP codes, with ZIP code 92316 accounting for nearly all Medicaid payments tied to this category in 2024, reaching a total of $550,547. The single highest-billing ZIP code made up 100% of category payments citywide for the year.

Within Evaluation and Management, Medicaid spending was centralized within a few specific billing codes.

Over the period from 2023 to 2024, Medicaid payments linked to Evaluation and Management climbed 33.5% in Bloomington, while the increase for all Medicaid claim categories was 1.5% over the same period.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending totaled approximately $871.7 billion in the 2023 fiscal year, reflecting about 18% of nationwide health expenditures, up from roughly $613.5 billion in 2019, prior to the COVID-19 pandemic.

This increase—about 40%—was driven mainly by broader enrollment and increased service use during and following the pandemic.

Recent federal budget measures signed into law under the Trump administration proposed major reductions to Medicaid support. The “One Big Beautiful Bill Act,” became law in 2025 and is set to reduce federal Medicaid spending by more than $1 trillion over the next 10 years. It also brings new policies, such as work requirements and increased cost-sharing, which could lead to reduced coverage and funding for certain beneficiaries. These shifts are expected to increase state-level financial responsibility and slow growth in the federal contribution to Medicaid, though the program continues to serve millions nationwide.

Note: HCPCS codes are included for context within the category. The category rankings and totals cited in this article are calculated based on standardized groupings, not individual billing codes.

Article information is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the source data here.