Laguna Hills Medicaid Evaluation and Management payments climb to $2,844,516 in 2024

In 2024, Medicaid providers in Laguna Hills billed a total of $2,844,516 for Evaluation and Management category services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 3.3% rise from 2023, when $2,754,143 in claims were made for these services.

Medicaid operates as a public health insurance plan managed by states and funded through a partnership of federal and state governments. It covers groups including low-income individuals, families, seniors, children, and people with disabilities, making it a major component of the U.S. health care sector.

Because taxpayer funding supports Medicaid, local billing changes indicate how public health funding is deployed at the community level.

The “Evaluation and Management” grouping encompasses a range of Medicaid-billed services identified by care type and based on standardized HCPCS and CPT codes. This analysis assigned each billing code to one specific service grouping by using uniform code prefixes and number ranges, enabling related services to be tracked together without overlap and allowing for precise rankings over time.

While Medicaid outlays rose across many service categories, Evaluation and Management was the third highest by total payments among categories in Laguna Hills for 2024.

Statewide, Evaluation and Management stood as the second-largest Medicaid payment category in California in 2024.

In Laguna Hills, over the five years preceding 2024, Medicaid payments tied to Evaluation and Management grew by $2,278,539—an increase of 402.6%. Some years, especially 2023 and 2022, recorded marked year-over-year spending jumps.

Although spending was distributed throughout the city, the majority of Medicaid payments for Evaluation and Management services concentrated in a small number of ZIP codes. In 2024, ZIP code 92653 saw $2,363,136 in payments, while 92656 reported $481,380. Altogether, these top 2 ZIP codes made up the full amount of Medicaid payments for this category in Laguna Hills that year.

Within Evaluation and Management, Medicaid payments largely focused on a select group of billing codes.

For reference, Evaluation and Management Medicaid payments in Laguna Hills went up 3.3% between 2024 and 2023, whereas Medicaid spending across all claim categories citywide changed by 8.9% over the same span.

According to the Centers for Medicare & Medicaid Services, combined state and federal Medicaid spending reached about $871.7 billion in fiscal year 2023, equaling roughly 18% of nationwide health expenditures and rising sharply from $613.5 billion in 2019 before the COVID-19 pandemic.

The increase amounts to roughly 40% growth in a few years, mainly due to higher enrollment and use during and after the pandemic.

Recent federal budget actions during the Trump administration have included major proposals to reduce federal Medicaid funding and restructure the program. The “One Big Beautiful Bill Act,” signed into law in 2025, is set to cut federal Medicaid spending by more than $1 trillion over 10 years. The law also introduces work requirements and increased cost-sharing, which could reduce funding and coverage for certain recipients. As a result, more costs are expected to shift to states, potentially limiting federal Medicaid growth even as the program continues to serve millions across the nation.

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.