In 2024, Franklinton Medicaid providers billed $2,796,445 for services classified under the Evaluation and Management category, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represented a 19.1% increase over 2023, when claims for these services totaled $2,347,155.
Medicaid is a public insurance program run by individual states and funded jointly by federal and state governments. The program provides coverage for low-income individuals and families, seniors, children, and people with disabilities, making it a major component of the U.S. health care system.
Since Medicaid payments rely on taxpayer funding, fluctuations in local billing reflect how public health care resources are allocated in a given community.
The “Evaluation and Management” classification includes a set of Medicaid-billed services grouped based on the nature of care, using standardized HCPCS and CPT code designations. For this report, each billing code was attributed to one service category using consistent code prefixes and ranges, which allowed for grouping related services and maintaining accuracy in rankings over time.
Medicaid expenditures increased across several service categories, with Evaluation and Management ranking second by total Medicaid payments in Franklinton in 2024.
Across Louisiana, Evaluation and Management placed third among Medicaid payment categories during 2024.
During the five-year period ending in 2024, Medicaid payments connected to the Evaluation and Management category in Franklinton rose by $1,884,271, or 206.6%. The growth rate accelerated during certain intervals, including significant year-over-year increases in 2023 and 2021.
While spending in the Evaluation and Management category took place throughout Franklinton, a small number of ZIP codes accounted for the largest share. In 2024, ZIP code 70438 saw Medicaid payments for the Evaluation and Management category totaling $2,796,445. This ZIP code represented 100% of all Evaluation and Management Medicaid payments in Franklinton for the year.
Payments within the Evaluation and Management category were also concentrated among a small set of individual billing codes.
For perspective, Medicaid payments related to Evaluation and Management in Franklinton grew by 19.1% from 2023 to 2024, while Medicaid claims for all categories in the city rose 13% over the same period.
According to the Centers for Medicare & Medicaid Services, combined federal and state spending on Medicaid reached about $871.7 billion in fiscal year 2023, or roughly 18% of all national health expenditures. That figure is up significantly from about $613.5 billion in 2019, prior to the COVID-19 pandemic.
This increase amounts to nearly 40% growth in just a few years, due largely to expanded enrollment and greater service use during and after the pandemic.
Recent federal budget measures under the Trump administration have proposed major reductions to federal Medicaid funding and reforms to the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid spending by more than $1 trillion over the next decade and introduce changes such as work requirements and higher cost-sharing that could reduce coverage and funding for certain beneficiaries. These reforms are anticipated to increase the financial responsibility for states and restrain the expansion of federal Medicaid support, even as the program continues to cover tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $912,173 | -26.6% |
| 2021 | $1,314,014 | 44.1% |
| 2022 | $1,602,468 | 22% |
| 2023 | $2,347,154 | 46.5% |
| 2024 | $2,796,445 | 19.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $4,690,065 | 46.1% |
| 2 | Evaluation and Management | $2,796,445 | 27.5% |
| 3 | National Codes Established for State Medicaid Agencies | $2,048,478 | 20.1% |
| 4 | Pathology and Laboratory Procedures | $267,183 | 2.6% |
| 5 | Medicine Services and Procedures | $126,964 | 1.2% |
| 6 | Alcohol and Drug Abuse Treatment | $104,962 | 1% |
| 7 | Radiology Procedures | $95,187 | 0.9% |
| 8 | Drugs Administered Other than Oral Method | $25,186 | 0.2% |
| 9 | Surgery | $9,193 | 0.1% |
| 10 | Procedures / Professional Services | $8,441 | 0.1% |
| 11 | Temporary Codes | $7,532 | 0.1% |
| 12 | Dental Services | $3,756 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99284 | Emergency dept visit mod mdm | $1,566,548 | 417 |
| 99285 | Emergency dept visit hi mdm | $632,088 | 233 |
| 99283 | Emergency dept visit low mdm | $418,066 | 108 |
| 99214 | Office o/p est mod 30 min | $103,948 | 119 |
| 99282 | Emergency dept visit sf mdm | $38,590 | 19 |
| 99213 | Office o/p est low 20 min | $19,856 | 89 |
| 99291 | Critical care first hour | $9,114 | 5 |
| 99215 | Office o/p est hi 40 min | $4,502 | 5 |
| 99051 | Med serv eve/wkend/holiday | $1,614 | 5 |
| 99292 | Critical care addl 30 min | $1,587 | 1 |
| 99309 | Sbsq nf care moderate mdm 30 | $339 | 9 |
| 99173 | Visual acuity screen | $188 | 21 |
| 99188 | App topical fluoride varnish | $0 | 4 |
| 99212 | Office o/p est sf 10 min | $0 | 8 |
| 99391 | Per pm reeval est pat infant | $0 | 16 |
| 99392 | Prev visit est age 1-4 | $0 | 17 |
| 99393 | Prev visit est age 5-11 | $0 | 7 |
| 99394 | Prev visit est age 12-17 | $0 | 8 |
| 99396 | Prev visit est age 40-64 | $0 | 1 |
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.
