Oneida Medicaid payments for Evaluation and Management services reach $79,177 in 2024

In 2024, providers in Oneida billed $79,177 to Medicaid for services categorized under Evaluation and Management, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This figure represents a 2.2% increase over 2023, when claims for the same service category totaled $77,482.

Medicaid is a public health insurance program operated by the states with joint funding from both federal and state governments. It provides coverage to low-income individuals and families, seniors, children, and people with disabilities, making it a major component of the U.S. health care system. For information about its funding, see this explanation.

Since taxpayer dollars support Medicaid, local billing changes highlight how a community’s public health care funds are distributed.

The “Evaluation and Management” category encompasses a range of Medicaid-billed services defined by the care type and standardized grouping of HCPCS and CPT codes. For this report, billing codes were grouped into a single service category based on consistent code ranges and prefixes, allowing for accurate tracking and rankings without double counting.

Evaluation and Management led all Medicaid service categories in total payments for Oneida in 2024, despite increases across multiple categories.

Statewide in Wisconsin, Evaluation and Management was the second-largest Medicaid category by total payments for 2024.

Between the five years leading up to 2024, Medicaid spending on Evaluation and Management services in Oneida grew by $29,804, or 60.4%. Notable surges occurred in 2023 and 2021, reflecting periods of faster growth.

Although Evaluation and Management spending occurred throughout the city, the majority was recorded in a small number of ZIP codes. In 2024, ZIP code 54155 alone accounted for $79,176 in Medicaid payments, representing 100% of the category’s total for Oneida that year.

Within this category, Medicaid billing was further concentrated among several key codes.

Comparing annual growth, Oneida saw a 2.2% increase for Evaluation and Management Medicaid payments from 2023 to 2024. This is set against a 16.1% increase across all Medicaid service categories in the community over the same period.

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

This increase marks approximately 40% growth in only a few years, largely due to expanded enrollment and higher use of services during and following the pandemic.

Federal budget measures enacted during the Trump administration brought notable proposals to scale back federal Medicaid spending and change the program’s structure. The “One Big Beautiful Bill Act,” signed into law in 2025, is anticipated to cut more than $1 trillion over the next decade and add policies such as work requirements and higher cost-sharing that may limit coverage and reduce funding for certain beneficiaries. These actions are projected to shift additional costs onto states and slow the growth of federal Medicaid support, all as the program remains vital for millions of people.

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.