Medicaid Evaluation and Management payments in Felton rise 81.8% to $35,674 in 2024

Felton Medicaid providers received $35,674 in payments for services under the Evaluation and Management category in 2024, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents an 81.8% increase over 2023, when $19,628 was billed for the same services.

Medicaid, overseen by state governments and funded in partnership with federal and state resources, insures low-income groups, older adults, children, and people living with disabilities, making it a cornerstone of the American health care framework.

Since Medicaid is supported by taxpayer funding, trends in local billing quantify how public health dollars are distributed at the community level.

The “Evaluation and Management” group encompasses Medicaid-billed services categorized by care type using established HCPCS and CPT codes. For this audit, each billing code was placed in one service category via consistent code prefixes and numerical groupings, supporting combined service analysis, preventing duplicate counts, and allowing for precise rank tracking over time.

Evaluation and Management ranked fourth in total Medicaid payments among service categories in Felton during 2024, with spending up in multiple sectors that year.

Statewide, the Evaluation and Management category ranked as the third largest in Delaware Medicaid payments in 2024.

From 2019 through 2024, Medicaid payments for Evaluation and Management in Felton grew by $34,981, or 5047.8%. There were periods of significant growth, with particularly large year-over-year jumps noted in 2021 and 2023.

Across Felton, Evaluation and Management spending was spread throughout the community, but the bulk of payments were tied to a small group of ZIP codes. In 2024, ZIP code 19943 alone saw $35,673 in these Medicaid payments, which accounted for 100% of the city’s Evaluation and Management totals that year.

Medicaid payments within this category were also clustered among a small number of billing codes.

When compared to the 81.8% increase in Felix’s Evaluation and Management Medicaid payments between 2023 and 2024, overall Medicaid spending for all categories in the city grew 28.1% during the same time frame.

According to the Centers for Medicare & Medicaid Services, combined Medicaid spending from federal and state sources approached $871.7 billion in fiscal year 2023, equating to around 18% of total national health care expenditures—a significant rise from the roughly $613.5 billion seen in 2019, prior to the COVID-19 pandemic.

This growth, estimated at nearly 40% over several years, has primarily resulted from higher enrollment and utilization rates during and after the pandemic period.

Federal budget moves under the Trump administration have included plans to significantly lower federal Medicaid outlays and alter the program’s structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years and introduces policies like work requirements and higher cost-sharing, measures that may decrease coverage and federal funding for certain recipients. The measures could push more costs onto states and slow future federal Medicaid increases even as millions rely on the program.

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.