In 2024, providers serving Medicaid patients in Cedar City submitted $3,037,119 in claims for Evaluation and Management services, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 3% uptick from 2023, when claims for the same services reached $2,950,008.
Medicaid, a health insurance initiative administered by states and financed by both federal and state governments, covers low-income families and individuals, seniors, children and individuals with disabilities. It is one of the largest programs in the U.S. health care system.
Because Medicaid is funded by taxpayers, trends in local billing highlight how health care resources are directed within the community.
The “Evaluation and Management” grouping refers to a category of Medicaid services defined by care type, based on standard HCPCS and CPT coding. In this analysis, codes were assigned to a single service grouping through accepted prefix and numeric ranges, allowing similar services to be reviewed collectively without duplication and ensuring accurate comparisons over time.
While Medicaid expenditures grew in several categories, Evaluation and Management services ranked as the top category in Cedar City for total Medicaid payments in 2024.
Across Utah, Evaluation and Management was the third highest Medicaid payment category in 2024.
Between 2019 and 2024, Medicaid payments in Cedar City for Evaluation and Management rose by $1,177,417, or 63.3%. Notable annual increases occurred in 2021 and 2022, indicating periods of faster growth.
Although these services are provided throughout Cedar City, most Medicaid payments were found in a few ZIP codes. For 2024, the ZIP codes 84721 and 84720 contributed $2,176,397 and $860,721 respectively, together representing all Medicaid Evaluation and Management spending in the city for the year.
A small number of individual billing codes accounted for the majority of Evaluation and Management Medicaid payments in Cedar City.
For context, Cedar City saw a 3% year-over-year increase in Medicaid Evaluation and Management payments from 2023 to 2024, whereas the citywide average across all Medicaid categories rose by 6.3% in that same period.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid outlays reached about $871.7 billion in fiscal year 2023, making up roughly 18% of all U.S. health expenditures. This is a sharp increase compared to the approximately $613.5 billion spent in 2019, prior to the COVID-19 pandemic.
This almost 40% surge in spending was largely caused by greater enrollment numbers and higher utilization during and following the pandemic.
Legislation passed under the Trump administration contains significant proposals to scale back federal spending on Medicaid and alter its structure. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid spending by more than $1 trillion over the coming decade, introducing work requirements and higher cost-sharing that could reduce access and funding for some enrollees. These measures may increase the financial responsibility borne by states and slow the growth of federal support, while the program continues to cover millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,859,702 | 2.9% |
| 2021 | $2,744,242 | 47.6% |
| 2022 | $3,740,320 | 36.3% |
| 2023 | $2,950,008 | -21.1% |
| 2024 | $3,037,119 | 3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $3,037,119 | 62.5% |
| 2 | Medicine Services and Procedures | $967,278 | 19.9% |
| 3 | Dental Services | $405,918 | 8.4% |
| 4 | Alcohol and Drug Abuse Treatment | $181,447 | 3.7% |
| 5 | National Codes Established for State Medicaid Agencies | $77,549 | 1.6% |
| 6 | Durable Medical Equipment | $56,381 | 1.2% |
| 7 | Pathology and Laboratory Procedures | $54,369 | 1.1% |
| 8 | Anesthesia | $29,623 | 0.6% |
| 9 | Surgery | $21,115 | 0.4% |
| 10 | Vision Services | $12,567 | 0.3% |
| 11 | Medical And Surgical Supplies | $6,903 | 0.1% |
| 12 | Radiology Procedures | $5,770 | 0.1% |
| 13 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $1,977 | <0.1% |
| 14 | Procedures / Professional Services | $360 | <0.1% |
| 15 | Drugs Administered Other than Oral Method | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $1,246,946 | 131 |
| 99214 | Office o/p est mod 30 min | $778,626 | 117 |
| 99284 | Emergency dept visit mod mdm | $282,466 | 56 |
| 99212 | Office o/p est sf 10 min | $204,085 | 30 |
| 99285 | Emergency dept visit hi mdm | $198,001 | 14 |
| 99283 | Emergency dept visit low mdm | $103,419 | 46 |
| 99203 | Office o/p new low 30 min | $74,564 | 19 |
| 99391 | Per pm reeval est pat infant | $41,420 | 25 |
| 99204 | Office o/p new mod 45 min | $30,090 | 10 |
| 99392 | Prev visit est age 1-4 | $25,833 | 21 |
| 99393 | Prev visit est age 5-11 | $16,610 | 16 |
| 99202 | Office o/p new sf 15 min | $12,550 | 14 |
| 99291 | Critical care first hour | $5,439 | 2 |
| 99394 | Prev visit est age 12-17 | $4,284 | 6 |
| 99309 | Sbsq nf care moderate mdm 30 | $4,114 | 11 |
| 99223 | 1st hosp ip/obs high 75 | $2,703 | 2 |
| 99232 | Sbsq hosp ip/obs moderate 35 | $2,059 | 2 |
| 98941 | Chiropract manj 3-4 regions | $1,396 | 3 |
| 99460 | Init nb em per day hosp | $886 | 1 |
| 99238 | Hosp ip/obs dschrg mgmt 30/< | $635 | 1 |
Note: HCPCS codes are provided for reference within the category. Article rankings and totals are calculated by standardized service groupings instead of individual 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.
