Evaluation and Management Medicaid claims reached $1,120,531 in Holly Springs for 2024

In 2024, providers in Holly Springs submitted $1,120,531 in Medicaid claims 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 total represents a 15.2% increase over 2023, when $972,888 in claims were recorded for the same type of service.

Medicaid is a public insurance program administered by states and supported jointly by federal and state governments. It serves low-income individuals and families, seniors, children, and those with disabilities, making it a core element of the U.S. health system.

Since Medicaid’s funding is derived from taxpayers, fluctuations in local billing reflect how health care funds are distributed within communities.

The “Evaluation and Management” classification groups Medicaid-billed services based on the care type, using standardized HCPCS and CPT code sets. For reporting, billing codes were organized into unique service categories using consistent code prefixes and numeric ranges, ensuring related services are analyzed together and double counting is avoided for accurate historical comparisons.

Among Medicaid service categories in Holly Springs, Evaluation and Management led in total payments for 2024.

Statewide in North Carolina, Evaluation and Management stood as the second-highest Medicaid payment category in 2024.

In the five years preceding 2024, Holly Springs saw a $647,614 increase—equivalent to 136.9% growth—in Medicaid payments related to Evaluation and Management. Spending growth was especially notable in specific years, with substantial annual increases marked in 2021 and 2022.

Although Evaluation and Management services were provided citywide, payment totals were predominantly concentrated into a small number of ZIP codes. In 2024, ZIP code 27540 accounted for $1,120,530, representing 100% of these Medicaid payments in Holly Springs for the Evaluation and Management group during that year.

Within this group, the majority of Medicaid spending focused on a select few billing codes.

To compare, Medicaid payment volume for Evaluation and Management services in Holly Springs grew 15.2% between 2024 and 2023. Across all Medicaid service categories over the same period, the change was 10.1%.

According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures combined totaled approximately $871.7 billion in the 2023 fiscal year, making up roughly 18% of all national health spending. This reflects a sharp rise from around $613.5 billion in 2019, ahead of the COVID-19 pandemic.

This surge represents an increase of close to 40% in a few years, propelled largely by expanded enrollment and heightened use during and soon after the pandemic period.

Federal legislation passed during the Trump administration has included notable measures to trim Medicaid funding and alter program structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next decade. The law introduces policies such as new work requirements and higher cost-sharing, potentially limiting coverage and reducing funding for certain groups. As a result, states may face increased financial responsibilities and restricted growth of federal Medicaid support, though the program will continue to cover tens of millions of Americans.

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.