Knightdale Medicaid Evaluation and Management spending rises to $1.6 million in 2024

In 2024, Medicaid providers in Knightdale billed $1,603,777 for Evaluation and Management services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total reflects a 33.6% rise from 2023, when providers claimed $1,199,990 for the same service category.

Medicaid is a joint state and federally funded public health insurance program covering low-income individuals and families, seniors, children, and people with disabilities. It is a significant component of the U.S. health care system.

Changes in Medicaid billing amounts highlight how public health care funding is allocated within a community, as the payments are sourced from taxpayers.

The “Evaluation and Management” category includes Medicaid-billed services defined by care type, identified through specific HCPCS and CPT code groupings. Under this methodology, each billing code was allocated to a unique service category using consistent prefixes and numeric ranges, ensuring related services are grouped together without duplication and that rankings over time remain accurate.

Spending in multiple Medicaid service categories increased, with Evaluation and Management leading all payment categories in Knightdale for 2024.

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

From 2019 to 2024, Evaluation and Management Medicaid payments in Knightdale climbed by $1,382,444, or 624.6%. Particularly strong growth was observed in certain years, such as 2021 and 2022.

While the distribution of spending for Evaluation and Management services occurred citywide, payments were heavily focused in a small number of ZIP codes. In 2024, the 27545 ZIP code recorded $1,603,776 in Medicaid payments for this category, making up 100% of such spending in Knightdale during the year.

Within this service grouping, a small set of billing codes accounted for most Medicaid payments.

Between 2024 and 2023, Evaluation and Management Medicaid payments in Knightdale grew by 33.6%, compared to a 21% overall change across all Medicaid claim categories locally in that period.

Centers for Medicare & Medicaid Services data show that combined federal and state Medicaid expenditures reached about $871.7 billion in fiscal year 2023. This accounted for roughly 18% of total national health spending, up significantly from $613.5 billion in 2019, ahead of the COVID-19 pandemic.

This growth represents an increase of about 40% in the past few years, largely due to expanded enrollment and increased service use during and after the pandemic.

In recent years, federal budget legislation during the Trump administration introduced major plans to reduce Medicaid funding and change its structure. The “One Big Beautiful Bill Act,” enacted in 2025, is forecast to cut federal Medicaid spending by more than $1 trillion over the next decade and implement new work requirements and higher cost-sharing. These policies may reduce coverage and funding for some and shift more costs to states, which could curb future growth in federal spending, even as the Medicaid program continues covering 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.