In 2024, Bellevue Medicaid providers billed $5,633,694 for services within the Evaluation and Management category, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This represents a 5.9% increase from 2023, when claims in the same category amounted to $5,317,641.
Medicaid, a public health insurance initiative managed by states and funded through both federal and state governments, serves low-income individuals and families, seniors, children, and those with disabilities, making it a significant component of the nation’s health care landscape.
Shifts in Medicaid billing locally reflect how taxpayer-funded health care resources are distributed across communities.
The “Evaluation and Management” group consists of Medicaid-billed services determined by care type and organized by standardized HCPCS and CPT code designations. For this report, each billing code was assigned one service category, using unified coding prefixes and ranges, which helps ensure comparability and prevent double counting of services in rankings across years.
Spending for multiple Medicaid service categories rose, but Evaluation and Management held the second-highest spot in total Medicaid payments in Bellevue during 2024.
The Evaluation and Management category also ranked second by total payments statewide in Washington for 2024.
Across the five years prior to 2024, Medicaid payments secured for Evaluation and Management services in Bellevue climbed by $3,507,612, or 165%. Growth rates varied annually, with notable spikes occurring in 2022 and 2021.
Payment distribution for Evaluation and Management services spanned the city, but most were concentrated within a select few ZIP codes. In 2024, ZIP code 98004 saw the highest total at $5,312,973, followed by 98005 at $166,677 and 98007 with $81,329. The top 3 ZIP codes collectively made up 98.7% of all Bellevue Medicaid payments in this category for the year.
Within this category, a small number of individual billing codes accounted for most Medicaid payments.
Comparatively, while Evaluation and Management Medicaid payments in Bellevue increased by 5.9% between 2024 and 2023, all Medicaid claim categories across the city rose by just 1.6% during the same span.
Federal Centers for Medicare & Medicaid Services data show that combined federal and state Medicaid expenditures reached around $871.7 billion in fiscal 2023, representing about 18% of health spending nationally, a sharp rise from $613.5 billion in 2019, before the pandemic.
This increase amounts to roughly 40% growth in several years, fueled largely by more enrollees and heightened utilization during and after the pandemic.
Recent federal legislation during the Trump administration included substantial proposals to cut federal funding for Medicaid and make programmatic changes. The “One Big Beautiful Bill Act,” enacted in 2025, is set to lower federal Medicaid expenditures by more than $1 trillion over a decade and introduces provisions like work requirements and greater cost-sharing, possibly reducing coverage and funding for some recipients. These measures are projected to increase the financial burden on states and slow the rise of federal Medicaid aid despite the program’s continued reach to millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $2,126,081 | 8.1% |
| 2021 | $3,051,473 | 43.5% |
| 2022 | $4,654,047 | 52.5% |
| 2023 | $5,317,640 | 14.3% |
| 2024 | $5,633,694 | 5.9% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $20,786,769 | 69.8% |
| 2 | Evaluation and Management | $5,633,694 | 18.9% |
| 3 | Medicine Services and Procedures | $1,214,558 | 4.1% |
| 4 | Dental Services | $560,837 | 1.9% |
| 5 | Radiology Procedures | $493,508 | 1.7% |
| 6 | Drugs Administered Other than Oral Method | $355,990 | 1.2% |
| 7 | Pathology and Laboratory Procedures | $288,833 | 1% |
| 8 | Surgery | $179,560 | 0.6% |
| 9 | Procedures / Professional Services | $148,270 | 0.5% |
| 10 | Ambulance and Other Transport Services and Supplies | $103,235 | 0.3% |
| 11 | Medical And Surgical Supplies | $15,311 | 0.1% |
| 12 | Durable Medical Equipment | $7,717 | <0.1% |
| 13 | Outpatient PPS | $5,218 | <0.1% |
| 14 | Anesthesia | $490 | <0.1% |
| 15 | Temporary Codes | $47 | <0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $3 | <0.1% |
| 17 | Alcohol and Drug Abuse Treatment | $0 | <0.1% |
| 17 | Temporary National Codes (Non-Medicare) | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99309 | Sbsq nf care moderate mdm 30 | $1,168,391 | 485 |
| 99310 | Sbsq nf care high mdm 45 | $963,279 | 294 |
| 99284 | Emergency dept visit mod mdm | $446,247 | 141 |
| 99214 | Office o/p est mod 30 min | $433,051 | 357 |
| 99283 | Emergency dept visit low mdm | $314,644 | 15 |
| 99285 | Emergency dept visit hi mdm | $312,357 | 133 |
| 99213 | Office o/p est low 20 min | $291,000 | 392 |
| 99204 | Office o/p new mod 45 min | $273,639 | 116 |
| 99308 | Sbsq nf care low mdm 20 | $256,667 | 154 |
| 99282 | Emergency dept visit sf mdm | $195,005 | 14 |
| 99306 | 1st nf care high mdm 50 | $142,694 | 81 |
| 99490 | Chrnc care mgmt staff 1st 20 | $133,059 | 142 |
| 99349 | Home/res vst est mod mdm 40 | $85,262 | 56 |
| 99203 | Office o/p new low 30 min | $78,143 | 62 |
| 99233 | Sbsq hosp ip/obs high 50 | $66,846 | 38 |
| 99439 | Chrnc care mgmt staf ea addl | $62,903 | 69 |
| 99232 | Sbsq hosp ip/obs moderate 35 | $59,056 | 25 |
| 99281 | Emr dpt vst mayx req phy/qhp | $39,477 | 10 |
| 99441 | $33,646 | 49 | |
| 99223 | 1st hosp ip/obs high 75 | $32,989 | 26 |
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.
