Eau Claire Medicaid Evaluation and Management payments up 4.1% in 2024

According to data from the U.S. Department of Health and Human Services Medicaid Provider Spending database, Medicaid providers in Eau Claire submitted $14,084 in 2024 for services under the Evaluation and Management category. This represents a 4.1% increase compared with 2023, when providers billed $13,531 for these services.

Medicaid is a public health insurance program managed by the states and funded in partnership with federal and state governments. It provides coverage for low-income individuals and families, seniors, children, and those with disabilities, making it one of the key components of the U.S. health care system.

Since Medicaid funding is sourced from taxpayers, shifts in local billing levels highlight how community health care funds are distributed.

The “Evaluation and Management” category includes services billed to Medicaid that are identified by the type of care provided, referencing standard HCPCS and CPT code groupings. The analysis uses consistent code prefixes and number ranges to assign billing codes to a single service category, which allows for comparisons over time while preventing double counting and supporting precise rankings.

While Medicaid expenditures grew across a range of service categories, Evaluation and Management placed third in Eau Claire in 2024 based on total Medicaid billing.

Statewide in Michigan, the Evaluation and Management category also ranked third in total Medicaid payments in 2024.

From five years prior through 2024, Medicaid payments for the Evaluation and Management category in Eau Claire rose by $7,963, equal to growth of 130.1%. The rate of spending increased notably in certain periods, particularly in 2023 and 2022.

Though spending on Evaluation and Management services was distributed throughout Eau Claire, most payments were concentrated in a small number of ZIP codes. In 2024, ZIP code 49111 recorded $14,084 in Medicaid payments for this category. This ZIP code alone made up 100% of Medicaid Evaluation and Management payments in Eau Claire for the year.

Within Evaluation and Management, a limited number of specific billing codes accounted for most Medicaid payments.

Comparing spending levels, Medicaid payments for Evaluation and Management increased by 4.1% from 2023 to 2024 in Eau Claire, while all Medicaid claim categories combined in the city saw a 22.7% change in the same period.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending reached about $871.7 billion during fiscal year 2023, which accounted for approximately 18% of all U.S. health expenditures. This marks a sharp increase from roughly $613.5 billion in 2019, before the COVID-19 pandemic began.

The nearly 40% rise over several years was mainly fueled by broader enrollment and greater health care utilization during and after the pandemic.

Recent federal budget actions during the Trump administration have featured major proposals to lower federal Medicaid funding and change the program’s structure. The “One Big Beautiful Bill Act,” signed in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next decade. It includes measures such as work requirements and increased cost-sharing, which could narrow coverage and funding for some recipients. The changes are likely to shift more spending responsibilities to states and restrain federal Medicaid growth as the program continues supporting 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.