Vacaville sees 464.1% surge in Medicaid Evaluation and Management payments in 2024

In 2024, Medicaid providers in Vacaville billed $7,646,859 for services under the Evaluation and Management classification, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a 464.1% jump from 2023, when billed claims for these services totaled $1,355,478.

Medicaid is a public health insurance initiative managed by states and funded in partnership with federal and state governments. It covers low-income residents, families, seniors, children, and individuals with disabilities, making it a major component of the U.S. health care system.

Because taxpayer funding supports Medicaid, shifts in local billing reflect how public funds are distributed for health care within communities.

The “Evaluation and Management” category covers a set of Medicaid-billed services, defined by care type and outlined by standard HCPCS and CPT code groupings. Each billing code was assigned to one service category using a consistent approach with code prefixes and number ranges to ensure accurate and non-duplicative comparisons across periods and service groups.

While multiple service categories saw increased Medicaid spending, Evaluation and Management ranked at the top in Vacaville for total Medicaid payments in 2024.

Statewide in California, Evaluation and Management placed second by total Medicaid payments in 2024.

Across the five-year span ending in 2024, Medicaid payments for the Evaluation and Management category in Vacaville grew by $6,785,018, amounting to a 787.3% rise. The rate of growth accelerated at several points, notably in 2022 and 2023.

Although such spending was recorded throughout Vacaville, payments were concentrated within a few ZIP codes. In 2024, ZIP code 95688 accounted for $6,792,005 and 95687 for $854,853 within this category. Together, these two areas represented 100% of Medicaid Evaluation and Management payments in the city for the year.

Within Evaluation and Management, Medicaid payments also focused on a small group of billing codes.

To compare, Medicaid Evaluation and Management payments in Vacaville rose 464.1% between 2024 and 2023. Across all Medicaid claim categories citywide, the increase was 37.7% for the same period.

The Centers for Medicare & Medicaid Services report that federal and state Medicaid spending together reached about $871.7 billion in fiscal year 2023, making up roughly 18% of national health spending. This was a sharp rise from around $613.5 billion in 2019, before the COVID-19 pandemic.

This represents nearly 40% growth in just a few years, mainly due to expanded participation and increased service use during and after the pandemic.

Recent federal budget laws passed under the Trump administration include major proposals to cut federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid spending by over $1 trillion in the next decade. It introduces requirements such as mandatory work and higher cost-sharing, which could affect coverage and funding for certain beneficiaries. These measures are likely to shift more financial responsibilities to states and restrict growth in federal support, even as Medicaid remains an essential safety net for many 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.