Cary Medicaid Evaluation and Management payments rise to $7,652,166 in 2024

Cary Medicaid providers billed $7,652,166 in 2024 for services falling under the Evaluation and Management category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This amount represents a 10.2% rise compared to 2023, when providers submitted $6,941,773 in eligible claims for these services.

Medicaid operates as a public health insurance initiative managed by the states and financed through both federal and state funding. The program offers coverage to low-income families and individuals, seniors, children, and people with disabilities, accounting for a significant portion of the U.S. health care landscape.

As Medicaid dollars are sourced from taxpayer funds, shifts in local billing volumes reflect how health care resources are distributed within a given area.

The Evaluation and Management classification encompasses a set of Medicaid services categorized by care type, with codes structured according to standardized HCPCS and CPT groupings. For this report, each billing code was attributed to one service category based on code prefixes and associated numeric spans, enabling precise grouping without double counting and ensuring consistency in historical comparisons.

Medicaid expenditures increased across several service categories, with Evaluation and Management ranking as the second-largest category in Cary for total Medicaid payments in 2024.

At the statewide level, Evaluation and Management also held the second-place spot in North Carolina for Medicaid payment totals in 2024.

In the five years ending in 2024, Evaluation and Management-related Medicaid payments in Cary grew by $5,085,078—an increase of 198.1%. The payment growth was particularly strong in certain years, including notable jumps in 2021 and 2022.

While Evaluation and Management services were provided throughout Cary, the bulk of payments were concentrated in specific ZIP codes during 2024. The largest amounts went to ZIP code 27518 with $4,763,906, followed by 27511 at $1,064,898, and 27513 with $772,104. Combined, these three ZIP codes made up 86.3% of all local payments for Evaluation and Management under Medicaid for the year.

A small number of billing codes made up the majority of Medicaid payments within the Evaluation and Management classification.

Across all Medicaid claim categories in Cary, Evaluation and Management payments increased 10.2% from 2023 to 2024. By comparison, total Medicaid claim payments in the city rose by 4.6% in the same timeframe.

The Centers for Medicare & Medicaid Services noted that combined federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023, totaling around 18% of nationwide health spending—up from about $613.5 billion in 2019, before the COVID-19 emergency.

This rise amounts to roughly 40% growth in just a few years, largely driven by increased enrollment and greater program utilization during and after the pandemic.

Recent congressional budget legislation from the Trump administration featured prominent changes to federal Medicaid funding, impacting the program’s future trajectory. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to lower federal Medicaid outlays by more than $1 trillion over the coming decade and implement adjustments such as work requirements and heightened cost-sharing. These measures could trim coverage and funding for certain participants, shifting more fiscal responsibility to states and restricting the expansion of federal Medicaid contributions while the program remains critical to millions of American beneficiaries.

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.