Selden Medicaid providers billed $4,157,226 in 2024 for services within the Evaluation and Management category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represented a 1.1% increase compared to 2023, when providers billed $4,113,579 for the same services.
Medicaid is a public health insurance program operated by states and funded through both federal and state governments. It provides health coverage for low-income people and families, seniors, children, and people with disabilities, making it a major part of the U.S. health care system.
Because Medicaid is taxpayer-financed, shifts in local billing help illustrate how public health funds are distributed within a community.
The Evaluation and Management category encompasses a set of Medicaid-billed services organized by the nature of care provided, using specific HCPCS and CPT code ranges. Each billing code in this analysis was allocated to a single service group according to code prefix and number patterns, enabling a clear view of related services, avoiding overlaps and maintaining accurate historical comparisons.
While Medicaid expenditures rose in several categories, Evaluation and Management led Selden in total Medicaid payments for 2024.
Statewide in New York, Evaluation and Management ranked as the second-largest Medicaid payment category in 2024.
During the five years before 2024, Medicaid payments in Selden tied to Evaluation and Management grew by $885,142, an increase of 27.1%. Notable year-over-year growth was recorded especially in 2021 and 2022.
Though Evaluation and Management spending covered care provided across Selden, payments were mainly concentrated in a few ZIP codes. In 2024, ZIP code 11784 accounted for $4,157,225 in these Medicaid payments, representing 100% of Selden’s total for this service type.
Within Evaluation and Management, Medicaid payouts were focused on a small selection of billing codes.
Between 2023 and 2024, Medicaid payments tied to Evaluation and Management services in Selden increased by 1.1%; all Medicaid claim categories in the city saw a 4.7% change in the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures totaled about $871.7 billion for fiscal year 2023, or around 18% of total U.S. health spending, up significantly from approximately $613.5 billion in 2019, prior to the COVID-19 pandemic.
This jump marks nearly 40% growth in a few years, a change largely driven by increased enrollment and utilization during and following the pandemic.
Recent federal budget measures under the Trump administration have introduced sizable proposals to reduce federal Medicaid funding and alter program structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to decrease federal Medicaid spending by more than $1 trillion in the next 10 years and adds policies such as work requirements and greater cost-sharing, potentially cutting coverage and funds for certain recipients. These changes are forecasted to shift more costs to states and slow federal Medicaid funding growth, even as the program remains essential to millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $3,272,083 | -7.7% |
| 2021 | $5,047,803 | 54.3% |
| 2022 | $4,159,840 | -17.6% |
| 2023 | $4,113,579 | -1.1% |
| 2024 | $4,157,225 | 1.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $4,157,225 | 67% |
| 2 | Temporary National Codes (Non-Medicare) | $1,710,405 | 27.6% |
| 3 | Ambulance and Other Transport Services and Supplies | $215,437 | 3.5% |
| 4 | Medicine Services and Procedures | $89,339 | 1.4% |
| 5 | Dental Services | $24,627 | 0.4% |
| 6 | Vision Services | $3,558 | 0.1% |
| 7 | Pathology and Laboratory Procedures | $3,430 | 0.1% |
| 8 | Procedures / Professional Services | $1,482 | <0.1% |
| 9 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| 9 | National Codes Established for State Medicaid Agencies | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $2,276,982 | 47 |
| 99214 | Office o/p est mod 30 min | $1,310,222 | 14 |
| 99203 | Office o/p new low 30 min | $297,898 | 12 |
| 99204 | Office o/p new mod 45 min | $184,429 | 12 |
| 99215 | Office o/p est hi 40 min | $23,411 | 9 |
| 99391 | Per pm reeval est pat infant | $18,116 | 18 |
| 99393 | Prev visit est age 5-11 | $17,820 | 11 |
| 99394 | Prev visit est age 12-17 | $11,612 | 8 |
| 99392 | Prev visit est age 1-4 | $9,718 | 11 |
| 99212 | Office o/p est sf 10 min | $4,519 | 2 |
| 99396 | Prev visit est age 40-64 | $1,590 | 2 |
| 99395 | Prev visit est age 18-39 | $874 | 1 |
| 99173 | Visual acuity screen | $30 | 5 |
Note: HCPCS codes are provided for reference within the category. Category totals and ranking in this article are determined by standardized service groupings, not single billing codes.
Information for this article comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Find the source data here.
