Wendell Medicaid Evaluation and Management payments climb 48% in 2024

According to the U.S. Department of Health and Human Services Medicaid Provider Spending database, Medicaid providers in Wendell billed $534,709 for Evaluation and Management services in 2024. This reflects a 47.8% increase over 2023, when claims for these services totaled $361,672.

Medicaid is a government health insurance program that is administered by states and funded through both federal and state contributions. The program covers children, seniors, low-income families, and people with disabilities, representing one of the largest health care segments in the United States.

Because Medicaid funding is sourced from taxpayers, shifts in billing amounts directly impact how public health dollars are distributed within communities.

The “Evaluation and Management” category is defined by HCPCS and CPT code groupings that reflect the type of care delivered. Each billing code in this review was assigned to a single service category via consistent code prefixes and ranges, which enabled analysis of similar services collectively and ensured accurate comparisons and category rankings over time.

While Medicaid spending has risen across various service categories, Evaluation and Management led all categories in Wendell for total Medicaid payments in 2024.

At the state level in North Carolina, Evaluation and Management was ranked as the second-largest category by total payments in 2024.

Between 2019 and 2024, Medicaid payments associated with Evaluation and Management in Wendell increased by $190,553, up 55.4%. Certain periods saw more rapid growth, with notable year-over-year rises occurring in 2020 and 2021.

Although these services were accessed throughout the city, Medicaid payments were particularly concentrated in only a few ZIP codes. In 2024, the highest total for Evaluation and Management services was found in ZIP code 27591, accounting for $534,708. The leading ZIP code represented 100% of the total Medicaid Evaluation and Management payments in Wendell for the year.

A limited number of specific billing codes received the bulk of payments within the Evaluation and Management category.

When comparing categories, Medicaid payments for Evaluation and Management services in Wendell grew by 47.8% from 2023 to 2024, outpacing the overall 31.9% increase seen across all Medicaid claim categories in the city during the same period.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending reached approximately $871.7 billion during fiscal year 2023, making up around 18% of total national health expenditures. This is a substantial rise from the $613.5 billion reported in 2019, prior to the COVID-19 pandemic.

This increase marks about 40% growth in just several years, which analysts attribute mainly to broader enrollment and higher usage during and following the pandemic.

Recent federal budget legislation enacted under the Trump administration proposed major reductions in federal Medicaid funding and program restructuring. The “One Big Beautiful Bill Act,” passed in 2025, is projected to decrease federal Medicaid spending by more than $1 trillion over the next decade. It also enacts policies such as work requirements and increased cost-sharing that could limit coverage and reduce funding for some recipients. These changes are expected to place greater financial responsibility on states while curbing federal Medicaid growth, though the program still covers 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.