Redlands Medicaid E/M service payments rise to $38,678,507 in 2024

In 2024, Redlands Medicaid providers billed $38,678,507 for services classified as Evaluation and Management, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This was a 29.5% rise compared with 2023 figures, when providers submitted $29,873,323 in claims for these services.

Medicaid, a publicly funded health insurance program managed by the states and funded by a partnership of federal and state governments, covers low-income families and individuals, seniors, children, and people with disabilities, making it a major segment of the nation’s health care system.

Since Medicaid relies on taxpayer funding, shifts in local billing reflect how a community uses public health care resources.

The “Evaluation and Management” category refers to a set of services billed to Medicaid, organized under standardized HCPCS and CPT code groupings. In this analysis, each billing code was allocated to a single service category using specific code prefixes and numeric ranges to keep related services grouped by type and prevent duplicate counting, preserving accurate rankings over time.

Evaluation and Management ranked as the leading category by total Medicaid payments in Redlands in 2024, though Medicaid spending also increased in other service categories.

Across California, Evaluation and Management was the second-largest category by total Medicaid payments in 2024.

During the five years leading up to 2024, Medicaid payments within the Evaluation and Management category in Redlands grew by $25,103,749, or 184.9%. This spending accelerated at points, with substantial year-over-year increases in both 2023 and 2022.

While payments for Evaluation and Management care were distributed citywide, they were notably concentrated in a few ZIP codes. In 2024, the top ZIP codes by Medicaid payments were 92373, with $25,194,251, and 92374, with $13,484,255. Combined, these areas made up 100% of Evaluation and Management Medicaid payments in Redlands that year.

A small cluster of individual billing codes accounted for the bulk of Medicaid payments in the Evaluation and Management category.

By comparison, Medicaid payments for Evaluation and Management services in Redlands went up 29.5% from 2023 to 2024, while all Medicaid claim categories in the city saw an 18% change during the same period.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023—about 18% of total health expenditures nationwide—rising sharply from $613.5 billion in 2019 before the COVID-19 pandemic.

The increase represents a nearly 40% growth in just a few years, largely due to expanded enrollment and higher use of services during and after the pandemic period.

Federal budget measures under the Trump administration have introduced proposals to reduce federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act”, enacted in 2025, is projected to reduce federal Medicaid spending by more than $1 trillion over 10 years and includes requirements such as mandatory work participation and increased cost-sharing for some beneficiaries. These new policies are expected to push more costs back to states and slow future federal Medicaid support even as coverage remains widespread.

Note: HCPCS codes are displayed for context within the category. All totals and rankings in this story rely on the standardized grouping of service categories—not individual billing codes.

Data for this article is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original data set is available here.