Kilmarnock Medicaid billing for Evaluation and Management services rises to $1.2 million in 2024

Providers in Kilmarnock submitted Medicaid claims totaling $1,185,310 for services within the Evaluation and Management classification in 2024, based on records from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a 16% rise from 2023, when the total was $1,022,220 for similar services.

Medicaid, a state-administered program funded in partnership with federal and state governments, provides health coverage for low-income residents, seniors, children and individuals with disabilities. It is a leading component of the U.S. health care landscape.

As Medicaid is publicly funded, shifts in local claims provide insight into how taxpayer dollars for health care are distributed across communities.

The Evaluation and Management category includes a set of Medicaid services determined by type of medical care provided, organized according to established HCPCS and CPT coding systems. For this analysis, billing codes were grouped by consistent code prefixes and number ranges, ensuring no overlap and accurate ranking over time for related services.

Spending in the Evaluation and Management group led all Medicaid payment categories in Kilmarnock for 2024.

On the state level, Evaluation and Management was the third-highest category by total Medicaid payments in Virginia in 2024.

Between 2019 and 2024, Kilmarnock saw Medicaid payments for Evaluation and Management services rise by $703,267, or 145.9%. The highest year-over-year increases occurred in 2022 and 2023.

Medicaid payments for Evaluation and Management services in 2024 were predominantly concentrated within a small number of ZIP codes in the city. ZIP code 22482 reported the highest total for the category, at $1,185,310, accounting for 100% of Kilmarnock’s Medicaid payments for this group during the year.

Within this category, the majority of Medicaid dollars were tied to a limited subset of billing codes.

Over the same period, payments for all Medicaid claim categories citywide grew by 10.5%, compared to the 16% jump for Evaluation and Management claims in Kilmarnock between 2024 and 2023.

Centers for Medicare & Medicaid Services data show combined federal and state Medicaid expenditures totaled approximately $871.7 billion for fiscal year 2023, which was about 18% of national health spending. This amount is up from about $613.5 billion in 2019, before the COVID-19 emergency.

This represents around 40% growth in a few years, mainly due to expanded Medicaid enrollment and increased use of health care services during the and after-pandemic phases.

Legislation enacted under the Trump administration has included extensive suggestions for reducing federal Medicaid funds and changing program structure. The “One Big Beautiful Bill Act,” approved in 2025, is anticipated to trim more than $1 trillion in federal Medicaid spending in the next ten years. The law adds new requirements—including work conditions and increased out-of-pocket costs—which may impact coverage and funding for certain Medicaid recipients. These adjustments are expected to transfer more cost responsibility to states and place constraints on future federal support, even though Medicaid continues to cover millions of Americans.

Note: HCPCS codes are provided for context. Totals and rankings reflect broader service groupings instead of individual billing codes.

This article uses data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original source is available here.