Costa Mesa sees 35.2% rise in 2024 Medicaid payments for Evaluation and Management services

Health care providers participating in Medicaid in Costa Mesa reported $8,721,726 in billed services within the Evaluation and Management category for 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This represents a 35.2% rise from 2023, when claims for the same type of service reached $6,449,296.

Medicaid, the public health insurance managed by individual states and jointly funded by federal and state governments, covers low-income individuals, families, children, seniors, and people with disabilities. As one of the large components in the U.S. health care system, Medicaid plays a significant role in many communities.

Since Medicaid is funded with taxpayer dollars, any change in billing totals locally reflects a shift in the allocation of public health care funding.

The “Evaluation and Management” classification includes a range of Medicaid-billed services grouped based on standardized HCPCS and CPT code structures. All billing codes in this analysis were matched to a single service category using unified code prefixes and ranges to facilitate analysis of related services, ensure accuracy over time, and prevent duplicate counts.

Evaluation and Management ranked as the second largest service category by total Medicaid payments in Costa Mesa in 2024. Several other categories also posted spending gains.

Statewide in California, Evaluation and Management also finished as the second most funded category for Medicaid payments in 2024.

Over the five years to 2024, Costa Mesa Medicaid payments for Evaluation and Management services increased by $5,349,867, or 158.7%. Growth accelerated during particular periods, particularly with year-over-year increases appearing in 2023 and 2020.

Medicaid spending on Evaluation and Management services was found throughout Costa Mesa but was primarily focused in a few ZIP codes. In 2024, ZIP code 92626 led with $7,309,829, and 92627 accounted for $1,411,895—together comprising all Medicaid payments for Evaluation and Management services in the city that year.

A small selection of specific billing codes also concentrated the majority of Medicaid payments within the Evaluation and Management category.

Between 2023 and 2024 in Costa Mesa, Medicaid payments related to Evaluation and Management rose by 35.2%. By comparison, Medicaid payments across all claim categories citywide increased by 69.5% during that period.

Centers for Medicare & Medicaid Services data show that combined federal and state Medicaid expenditures totaled about $871.7 billion in fiscal year 2023—nearly 18% of total national health expenses—up sharply from about $613.5 billion in 2019, before the pandemic.

This reflects an increase of roughly 40% over several years, largely attributed to higher enrollment and service utilization during and after the COVID-19 pandemic period.

Recent federal budget laws during the Trump administration brought forward major efforts to scale back federal Medicaid spending and alter the structure of the program. The “One Big Beautiful Bill Act,” enacted in 2025, is projected to reduce federal Medicaid outlays by more than $1 trillion over the next decade. Provisions of the act, such as work requirements and new cost-sharing measures, may decrease both coverage and federal funding for some groups, shifting added costs to states as overall federal support grows more limited, though Medicaid still reaches millions nationwide.

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.