Murphy’s Medicaid providers invoiced $2,726,632 for services under the Evaluation and Management category in 2024, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This amount represents a 5.5% rise over 2023, when claimed services in this group reached $2,583,940.
Medicaid is administered at the state level and funded jointly by both state and federal governments. It provides coverage for people with low incomes, elderly adults, children, and individuals with disabilities, making up a substantial part of the U.S. health system.
Since Medicaid is taxpayer-funded, shifts in local claims directly impact how public health care spending is distributed in an area.
The “Evaluation and Management” category comprises services defined by the nature of the care, grouped by standard HCPCS and CPT codes. For this analysis, billing codes were assigned to categories using uniform prefixes and numeric series, helping examine aggregate trends while preventing duplicate counts and maintaining accurate service rankings over time.
Among several major service categories analyzed, Evaluation and Management received the highest Medicaid payment total in Murphy for 2024.
Statewide in North Carolina, Evaluation and Management ranked as the second-largest Medicaid service category by total payment in 2024.
Between 2020 and 2024, Evaluation and Management Medicaid payments in Murphy increased by $1,308,792, or 92.3%. Several years within that period saw especially strong growth, particularly in both 2022 and 2021.
Although care in the Evaluation and Management category occurred throughout Murphy, claim payments were concentrated within just a few ZIP codes. In 2024, the largest Medicaid payment total for this category—$2,726,632—came from ZIP code 28906. This one ZIP code made up 100% of Murphy’s Evaluation and Management Medicaid payments for the year.
Spending within the Evaluation and Management group tended to be focused on a handful of billing codes.
While Medicaid payments in Murphy for the Evaluation and Management category went up by 5.5% between 2023 and 2024, citywide claims spanning all categories climbed by 19.1% during the same period.
The Centers for Medicare & Medicaid Services report that in fiscal year 2023, federal and state Medicaid spending reached roughly $871.7 billion, comprising approximately 18% of the nation’s total health costs and up significantly from $613.5 billion in 2019, before the COVID-19 outbreak.
This surge signals nearly 40% growth over just several years, fueled primarily by increased participation and greater health care usage during and after the pandemic period.
Recent budget measures enacted during the Trump administration included significant changes to federal Medicaid allocations and program structure. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to achieve over $1 trillion in federal Medicaid savings through a decade and introduces new policies, such as work mandates and higher cost-sharing, which could narrow coverage and federal funding for select beneficiaries. These changes are likely to shift additional financial burdens to states and restrict future federal assistance, even as Medicaid supports tens of millions nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,417,840 | -24% |
| 2021 | $1,971,822 | 39.1% |
| 2022 | $2,767,762 | 40.4% |
| 2023 | $2,583,940 | -6.6% |
| 2024 | $2,726,632 | 5.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $2,726,632 | 27.7% |
| 2 | National Codes Established for State Medicaid Agencies | $2,240,646 | 22.8% |
| 3 | Medicine Services and Procedures | $1,518,859 | 15.4% |
| 4 | Temporary National Codes (Non-Medicare) | $1,430,351 | 14.5% |
| 5 | Alcohol and Drug Abuse Treatment | $1,374,390 | 14% |
| 6 | Ambulance and Other Transport Services and Supplies | $184,293 | 1.9% |
| 7 | Pathology and Laboratory Procedures | $154,082 | 1.6% |
| 8 | Radiology Procedures | $110,039 | 1.1% |
| 9 | Durable Medical Equipment | $64,153 | 0.7% |
| 10 | Dental Services | $10,067 | 0.1% |
| 11 | Drugs Administered Other than Oral Method | $6,980 | 0.1% |
| 12 | Surgery | $6,107 | 0.1% |
| 13 | Temporary Codes | $4,399 | <0.1% |
| 14 | Medical And Surgical Supplies | $2,787 | <0.1% |
| 15 | Procedures / Professional Services | $854 | <0.1% |
| 16 | Administrative, Miscellaneous and Investigational | $213 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99199 | Unlisted special svc px/rprt | $666,709 | 79 |
| 99214 | Office o/p est mod 30 min | $501,140 | 93 |
| 99213 | Office o/p est low 20 min | $418,739 | 103 |
| 99285 | Emergency dept visit hi mdm | $411,285 | 106 |
| 99284 | Emergency dept visit mod mdm | $316,399 | 125 |
| 99283 | Emergency dept visit low mdm | $89,666 | 59 |
| 99393 | Prev visit est age 5-11 | $74,528 | 21 |
| 99392 | Prev visit est age 1-4 | $66,901 | 20 |
| 99391 | Per pm reeval est pat infant | $53,726 | 11 |
| 99394 | Prev visit est age 12-17 | $49,579 | 17 |
| 99215 | Office o/p est hi 40 min | $28,093 | 11 |
| 99205 | Office o/p new hi 60 min | $13,700 | 6 |
| 99204 | Office o/p new mod 45 min | $10,345 | 6 |
| 99202 | Office o/p new sf 15 min | $9,400 | 9 |
| 99212 | Office o/p est sf 10 min | $8,219 | 10 |
| 99203 | Office o/p new low 30 min | $5,609 | 5 |
| 99173 | Visual acuity screen | $2,042 | 21 |
| 99211 | Off/op est may x req phy/qhp | $542 | 1 |
| 99000 | Specimen handling office-lab | $0 | 5 |
Note: HCPCS codes are listed to provide context within the category. Totals and rankings in this piece rely on standard service categories, not on each individual billing code.
The information in this piece was gathered from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Find the source data here.
