Providers in Dickson City billed $1,985,899 to Medicaid for Evaluation and Management services in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This figure represents a 0.3% uptick from 2023, when claims for these services totaled $1,980,542.
Medicaid is a health coverage program administered by individual states and financed through both federal and state funds. It provides health insurance to low-income families and individuals, seniors, children, and people with disabilities, making it a significant component of the nation’s health care structure.
Since Medicaid funds originate with taxpayers, shifts in billing activity at the local level indicate how publicly financed health care resources are distributed in each community.
The “Evaluation and Management” category is made up of Medicaid services grouped by the type of care delivered, as defined by standard HCPCS and CPT codes. In this study, billing codes were assigned to service categories using established code prefixes and number ranges, enabling accurate grouping, avoiding duplicated service counts, and ensuring proper year-to-year comparisons.
While Medicaid payment amounts rose in several categories, Evaluation and Management was the top category in Dickson City based on total Medicaid dollars paid out in 2024.
Statewide in Pennsylvania, Evaluation and Management ranked fourth for Medicaid payments among all categories in 2024.
From 2019 to 2024, total Medicaid spending for Evaluation and Management services in Dickson City grew by $1,885,499 or 1878%. This growth was especially notable in 2021 and 2020, when the largest year-over-year gains occurred.
Spending tied to Evaluation and Management services was present across Dickson City but focused in a few ZIP codes. In 2024, ZIP code 18519 accounted for $1,678,922 and 18508 for $306,976 in such payments. Combined, these two areas made up 100% of all Medicaid Evaluation and Management payments in Dickson City for the year.
Only a small number of HCPCS billing codes dominated Evaluation and Management Medicaid reimbursements within the city.
Between 2023 and 2024 in Dickson City, Medicaid payments for Evaluation and Management services increased by 0.3%, compared to an 8.6% change for all Medicaid service categories in the city during the same period.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid costs were about $871.7 billion in the federal fiscal year 2023, making up roughly 18% of U.S. health care spending—up from approximately $613.5 billion in 2019, before the COVID-19 pandemic.
This increase amounts to nearly 40% in a few years, mainly due to expanded Medicaid enrollment and higher service use both during and after the pandemic.
Recent federal budget law signed during the Trump administration included sizable measures to reduce federal Medicaid spending and overhaul funding structures. The “One Big Beautiful Bill Act,” enacted in 2025, is set to cut federal Medicaid allocations by over $1 trillion over the coming decade and introduces work requirements and more cost-sharing, which could reduce both coverage and funding for some. This is expected to increase cost burdens on states and curb the expansion of federal Medicaid aid, despite continuing to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $100,399 | 632.8% |
| 2021 | $760,647 | 657.6% |
| 2022 | $1,308,628 | 72% |
| 2023 | $1,980,541 | 51.3% |
| 2024 | $1,985,898 | 0.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $1,985,898 | 66.8% |
| 2 | Durable Medical Equipment | $325,698 | 11% |
| 3 | Pathology and Laboratory Procedures | $293,595 | 9.9% |
| 4 | Medicine Services and Procedures | $155,426 | 5.2% |
| 5 | Medical And Surgical Supplies | $94,525 | 3.2% |
| 6 | Radiology Procedures | $94,495 | 3.2% |
| 7 | Orthotic Procedures and services | $16,820 | 0.6% |
| 8 | Vision Services | $1,988 | 0.1% |
| 9 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $1,777 | 0.1% |
| 10 | Procedures / Professional Services | $800 | <0.1% |
| 11 | Drugs Administered Other than Oral Method | $3 | <0.1% |
| 12 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 12 | Temporary Codes | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99284 | Emergency dept visit mod mdm | $751,427 | 119 |
| 99283 | Emergency dept visit low mdm | $313,110 | 89 |
| 99214 | Office o/p est mod 30 min | $303,807 | 82 |
| 99285 | Emergency dept visit hi mdm | $176,246 | 43 |
| 99213 | Office o/p est low 20 min | $155,570 | 83 |
| 99204 | Office o/p new mod 45 min | $89,235 | 12 |
| 99393 | Prev visit est age 5-11 | $44,926 | 37 |
| 99392 | Prev visit est age 1-4 | $44,738 | 34 |
| 99394 | Prev visit est age 12-17 | $31,455 | 25 |
| 99391 | Per pm reeval est pat infant | $30,059 | 26 |
| 99203 | Office o/p new low 30 min | $19,083 | 9 |
| 98940 | Chiropract manj 1-2 regions | $15,440 | 22 |
| 99212 | Office o/p est sf 10 min | $9,029 | 12 |
| 98941 | Chiropract manj 3-4 regions | $1,493 | 4 |
| 99173 | Visual acuity screen | $273 | 4 |
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.
