Utah Medicaid Evaluation and Management payments reach $113,851,202 in 2024

Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show Utah Medicaid payments totaled $113,851,202 in 2024 for services grouped under the Evaluation and Management category. This amount reflects a 5.7% rise compared to 2023, when claims reached $107,680,254.

Comparisons to previous years in this article are based on the most recent year with available information.

Medicaid, a state-administered, jointly funded public insurance program, supports low-income individuals and families, seniors, children, and those with disabilities. It remains one of the largest programs within the U.S. health care system. Additional details on funding are available on how payments are split between federal and state governments.

Local Medicaid billing shifts highlight how taxpayer resources are distributed for health care locally.

The Evaluation and Management grouping encompasses a range of Medicaid-reimbursed care types, determined by specific, standardized HCPCS and CPT codes. For analytical purposes, billing codes were matched to one service category with consistent use of code ranges and prefixes. This approach links related services for better comparison, maintains accurate rankings, and avoids double counting.

These categories may cover multiple service types. When present, such categories combine related care forms that are often billed together through Medicaid, such as office visit charges, diagnostics, and therapy procedures.

Between 2019 and 2024, Utah’s Medicaid spending for Evaluation and Management services rose by $52,581,325, representing 85.8% growth. Notably, there were accelerated increases in spending during 2021 and 2022.

While Evaluation and Management expenditures occurred across the state, a significant portion was concentrated by ZIP code. In 2024, ZIP Code 84113 received $8,683,352—or 7.6% of the total—while ZIP Code 84102 had $7,922,001 (7%), and ZIP Code 84604 saw payments of $7,543,572 (6.6%).

Together, these three ZIP codes were responsible for 21.2% of Utah’s Evaluation and Management Medicaid payments for the year.

By comparison, the increase for Medicaid payments across all service categories throughout the state from 2023 to 2024 was 1.4%.

Although spending went up in several service areas, Evaluation and Management was among Utah’s top three largest payment categories in 2024.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023. This made up about 18% of all national health expenditures, rising from around $613.5 billion in 2019, prior to the COVID-19 pandemic.

This represents roughly 40% growth over several years, largely influenced by rising enrollment numbers and greater utilization during and after the pandemic.

Recent federal legislation from the Trump administration brought notable proposals to reduce federal Medicaid funding and change program operations. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid expenses by more than $1 trillion over the next decade. It introduces requirements—such as work conditions and higher out-of-pocket costs for beneficiaries—that could reduce access and federal support, placing increased pressure on state budgets even while Medicaid covers tens of millions of people nationally.