In 2024, Medicaid providers in Inwood submitted claims totaling $320,289 for Evaluation and Management services, as reported in the U.S. Department of Health and Human Services Medicaid Provider Spending database. This total represents a 74.6% jump from 2023, when claims in this service category totaled $183,470.
Medicaid, a joint effort between federal and state governments, is a public health insurance program that serves low-income individuals, families, children, seniors, and people with disabilities, making it a major component of the U.S. health care system. More details on Medicaid funding can be found here.
Changes in the amount of Medicaid funds billed locally reflect how taxpayer-funded public health care dollars are distributed within the community.
The “Evaluation and Management” classification covers Medicaid-billed services defined by the nature of care provided, grouped according to standardized HCPCS and CPT code ranges. In this analysis, billing codes were consistently assigned to a single service category to group related services accurately, prevent double counting, and allow reliable year-to-year comparisons.
Even though total Medicaid spending increased across several service types, Evaluation and Management was the second-largest category for Medicaid payments in Inwood in 2024.
Statewide in New York, Evaluation and Management was also the second-highest category for Medicaid payments in 2024.
Between 2019 and 2024, Inwood saw Medicaid payments tied to Evaluation and Management grow by $143,794, an 81.5% increase. There were particularly significant year-over-year rises in 2021 and 2022.
Though Evaluation and Management spending was distributed throughout the city, a few ZIP codes received the majority of payments. In 2024, ZIP code 11096 accounted for $320,288 in Medicaid Evaluation and Management payments, making up 100% of these payments in Inwood for the year.
A small set of billing codes within the Evaluation and Management category represented most Medicaid payments in this group.
For reference, the 74.6% growth in Evaluation and Management payments between 2024 and 2023 was substantially higher than the 2.7% increase seen across all Medicaid claim categories in Inwood for the same period.
According to the Centers for Medicare & Medicaid Services, federal and state Medicaid expenditures totaled approximately $871.7 billion for fiscal year 2023. This made up about 18% of all U.S. health care spending and marked a significant rise from roughly $613.5 billion in 2019, before the COVID-19 pandemic.
This represents an increase of nearly 40% over several years, largely resulting from increased enrollment and higher service utilization during and following the pandemic.
Recent federal budget actions under the Trump administration have put forward major proposals to trim federal Medicaid funding and revamp the program. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid expenditures by more than $1 trillion over the next 10 years and introduces policies such as work requirements and greater cost-sharing, which could affect coverage and funding for certain beneficiaries. These measures are likely to shift financial responsibility to states and could slow future federal funding growth, while Medicaid continues to cover tens of millions of people nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $176,494 | -30.6% |
| 2021 | $269,921 | 52.9% |
| 2022 | $219,970 | -18.5% |
| 2023 | $183,469 | -16.6% |
| 2024 | $320,288 | 74.6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $22,562,504 | 98.4% |
| 2 | Evaluation and Management | $320,288 | 1.4% |
| 3 | Dental Services | $34,780 | 0.2% |
| 4 | Vision Services | $6,147 | <0.1% |
| 5 | Medicine Services and Procedures | $5,878 | <0.1% |
| 6 | Ambulance and Other Transport Services and Supplies | $3,519 | <0.1% |
| 7 | Surgery | $3,268 | <0.1% |
| 8 | Procedures / Professional Services | $2,946 | <0.1% |
| 9 | Pathology and Laboratory Procedures | $1,369 | <0.1% |
| 10 | Drugs Administered Other than Oral Method | $15 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $127,678 | 22 |
| 99214 | Office o/p est mod 30 min | $119,057 | 27 |
| 99203 | Office o/p new low 30 min | $27,055 | 10 |
| 99396 | Prev visit est age 40-64 | $25,700 | 12 |
| 99395 | Prev visit est age 18-39 | $17,493 | 12 |
| 99385 | Prev visit new age 18-39 | $2,283 | 3 |
| 99050 | Medical services after hrs | $828 | 6 |
| 99408 | Audit/dast 15-30 min | $164 | 1 |
| 99051 | Med serv eve/wkend/holiday | $28 | 1 |
| 99000 | Specimen handling office-lab | $0 | 13 |
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.
