Costa Mesa Medicaid spending on Evaluation and Management services jumps 35.2% in 2024

In 2024, Medicaid providers in Costa Mesa billed a total of $8,721,726 for services under the Evaluation and Management classification, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 35.2% increase compared with the prior year, when providers filed $6,449,296 in claims for the same category of services.

Medicaid, a public health insurance program managed by states and supported by both federal and state governments, covers low-income individuals and families, seniors, children, and those with disabilities. It is among the nation’s largest health care programs.

Because Medicaid draws on taxpayer funding, shifts in local billing levels provide insight into the allocation of public health care dollars within communities.

The Evaluation and Management category groups Medicaid-billed services according to the type of care, using standardized HCPCS and CPT code groupings. For analysis, each billing code was classified into a single service category based on code prefixes and numeric ranges to identify related services, eliminate double counting, and maintain consistent rankings over time.

While Medicaid spending went up in several service categories, Evaluation and Management ranked second in Costa Mesa for total Medicaid payments in 2024.

Statewide in California, the Evaluation and Management category also ranked second for overall Medicaid payments during 2024.

Over the five years through 2024, payments in Costa Mesa tied to Evaluation and Management rose by $5,349,867, an increase of 158.7%. Certain years saw accelerated growth, including notable year-over-year hikes in 2023 and 2020.

Within the city, spending for Evaluation and Management services was focused in a few ZIP codes. In 2024, ZIP code 92626 accounted for $7,309,829 and 92627 contributed $1,411,895. Together, these 2 ZIP codes made up 100% of the city’s Medicaid payments in this service category during the year.

Most Medicaid payments within the Evaluation and Management category were consolidated among a small selection of billing codes.

To compare, Costa Mesa saw a 35.2% increase in Medicaid payments for Evaluation and Management between 2024 and 2023. This was less than the overall 69.5% growth seen for all Medicaid claim categories in the city over the same period.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures were approximately $871.7 billion in fiscal year 2023, making up about 18% of total U.S. health costs, up significantly from $613.5 billion in 2019, before the COVID-19 pandemic.

This growth equates to around a 40% jump in just a few years, fueled mainly by greater enrollment and increased service use during and following the pandemic period.

The Trump administration’s recent federal budget bills proposed notable changes to Medicaid funding and program structure. The “One Big Beautiful Bill Act,” signed into law in 2025, is forecast to reduce federal Medicaid spending by more than $1 trillion over a decade, introducing measures such as work requirements and higher cost-sharing. These changes may reduce coverage and funding for a number of beneficiaries and could shift additional costs to the states, even as Medicaid serves 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.