Evaluation and Management Medicaid payments climb to $10,284,102 in Hendersonville for 2024

Hendersonville Medicaid providers received $10,284,102 in 2024 for services under the Evaluation and Management category, based on data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The total represents a 7.6% increase from 2023, when claims for the same services reached $9,561,654.

Medicaid is a government health insurance program administered by the states and paid for through a partnership of federal and state governments. It provides coverage for low-income people and families, seniors, children, and individuals with disabilities, making the program a key part of the U.S. health care structure.

Since Medicaid is funded by public dollars, variations in local billing practices illustrate how health care resources are distributed across a specific area.

The “Evaluation and Management” category includes a collection of services designated by the type of care delivered, organized according to standardized HCPCS and CPT code groups. For these figures, each billing code was grouped within a single service class using standard code prefixes and numerical sequences, which helps consolidate related services for analyses and avoids multiple counts or skewed rankings.

Spending went up across several Medicaid service groups, but Evaluation and Management contributed the highest Medicaid payment total in Hendersonville for 2024.

Across North Carolina, the Evaluation and Management category took second place for Medicaid service payment totals in 2024.

Looking at the previous five years leading up to 2024, Hendersonville’s Medicaid payments within Evaluation and Management surged by $6,613,609, or 180.2%. Growth rates accelerated in some years, notably 2021 and 2022, which saw larger increases year-over-year.

Payment distribution for Evaluation and Management services concentrated in few ZIP codes throughout the city. In 2024, ZIP code 28792 posted Medicaid payments totaling $7,634,992, followed by 28791 at $1,521,365 and 28739 at $1,127,744. These three ZIP codes together accounted for the entirety of Medicaid payments connected to the Evaluation and Management category in Hendersonville during 2024.

Within Evaluation and Management, only a small number of codes captured the majority of payments.

When measured against all Medicaid categories in Hendersonville, Evaluation and Management expenditures rose 7.6% between 2024 and the previous year, while overall Medicaid claim payments in the city increased by 1.5% for the same time period.

According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending hit approximately $871.7 billion in fiscal year 2023, accounting for close to 18% of total U.S. health care expenses. This figure is up sharply from nearly $613.5 billion in 2019, predating the COVID-19 pandemic.

The rise reflects roughly 40% growth over several years, with enrollment expansion and increased service use throughout and after the pandemic period seen as the main contributors.

Recent budget legislation signed during the Trump administration included substantial cuts to federal Medicaid funding and major program restructuring proposals. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to reduce federal Medicaid spending by over $1 trillion over 10 years and adds new requirements such as work mandates and higher cost sharing, which may affect program benefits for some groups. As a result, states could end up bearing a larger financial role while overall growth in federal Medicaid aid may slow, even as Medicaid remains a crucial source of health coverage nationwide.

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.