Fayetteville sees $8,986 in Medicaid payments for Evaluation and Management services in 2024

Medicaid providers in Fayetteville billed $8,986 for services within the Evaluation and Management category in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. Compared to 2023 when providers filed $8,623 in claims for similar services, this reflects a 4.2% increase.

Medicaid, a public health insurance program administered by the states and financed through a partnership between federal and state governments, serves low-income families and individuals, children, seniors, and people with disabilities, forming a major segment of the U.S. health care system.

Taxpayer funding supports Medicaid payments, so changes in local billing reflect how public health care resources are distributed in the area.

The Evaluation and Management category includes a series of Medicaid-billed services defined by type of care, based on standard HCPCS and CPT codes. In this reporting, each billing code was grouped into a single category using organized code prefixes and numerical ranges, ensuring that related services could be reviewed together, minimizing duplicate counting and maintaining accurate historical rankings.

Though Medicaid expenditures rose across several service categories, Evaluation and Management was the fourth highest for total Medicaid payments in Fayetteville in 2024.

Statewide in West Virginia, Evaluation and Management ranked as the second largest category by Medicaid payments in 2024.

Throughout the five years leading up to 2024, Fayetteville’s Medicaid payments for Evaluation and Management increased by $46,597, or 83.8%. Notable growth spikes were seen at certain points, including sizable increases in 2023 and 2022.

While spending in this category was distributed throughout Fayetteville, it was heavily concentrated in certain ZIP codes. The highest payments were reported in ZIP code 25840, totaling $8,986 in 2024. The top ZIP code accounted for the entirety of Evaluation and Management Medicaid payments in the city that year.

Within the category, most Medicaid payments were linked to only a small set of billing codes.

For context, Medicaid payments for the Evaluation and Management category in Fayetteville rose by 4.2% between 2024 and 2023, while all Medicaid claim categories in the city experienced a 22.5% increase over the same timeframe.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures reached approximately $871.7 billion during the 2023 fiscal year. This total represented about 18% of national health spending, a sharp jump from roughly $613.5 billion in 2019, prior to the COVID-19 crisis.

This shift illustrates an increase of nearly 40% in just a few years, mainly fueled by enrollment growth and greater utilization related to the pandemic era and its aftermath.

Recent federal legislation approved under the Trump administration brought major proposals to reduce federal Medicaid funding and alter the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is anticipated to cut more than $1 trillion from federal Medicaid outlays over the next decade. Measures include work mandates and increased cost-sharing, which may result in reduced benefits and lower funding for some recipients. Consequently, states are expected to bear more costs, and federal support growth will slow, while Medicaid remains essential to millions of Americans.

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.