Gardena Medicaid providers billed $21,621,167 for Evaluation and Management services in 2024, U.S. Department of Health and Human Services Medicaid Provider Spending data show. That figure represents a 6% rise from 2023, when claims for these services totaled $20,402,635.
Medicaid is a public health insurance initiative administered by states and financed collectively by federal and state governments. The program serves low-income people and families, seniors, children, and those with disabilities, making it a major segment of the nation’s health care system.
Because Medicaid is taxpayer-funded, fluctuations in local billing highlight changes in the allocation of public health dollars within a community.
The “Evaluation and Management” category groups Medicaid-billed services based on the type of care, using standardized HCPCS and CPT code ranges. For this report, each code was consistently assigned to a single category using established prefixes and numerical ranges to allow for accurate, non-duplicated analysis over time.
Evaluation and Management led all Medicaid service categories in Gardena by total payments in 2024, amid broader spending increases across multiple categories.
Statewide in California, Evaluation and Management was the second highest Medicaid service category by total payments in 2024.
Over the five years preceding 2024, Evaluation and Management-related Medicaid payments in Gardena rose by $17,112,822, or 379.6%. Growth in this spending was particularly strong in certain years, including 2023 and 2021.
Payments for Evaluation and Management services in 2024 were distributed through Gardena but were concentrated in a few ZIP codes. The largest sums came from ZIP code 90248 ($16,078,901), 90247 ($4,469,699), and 90249 ($1,072,566). Collectively, these top 3 ZIP codes represented 100% of all Medicaid Evaluation and Management payments in Gardena that year.
A small group of billing codes within the Evaluation and Management category accounted for most Medicaid payments.
From 2023 to 2024, Medicaid payments for Evaluation and Management services in Gardena grew by 6%, whereas Medicaid claims overall in the city increased by 1.8% over the same span.
Centers for Medicare & Medicaid Services data shows that combined federal and state Medicaid expenditures reached about $871.7 billion in fiscal 2023, or roughly 18% of all U.S. health spending—a substantial jump from $613.5 billion in 2019, before the COVID-19 pandemic.
This increase represents approximately 40% spending growth in a short period, largely the result of higher enrollment and usage during and after the pandemic.
Recent federal budget measures during the Trump administration have introduced substantial proposals to decrease federal Medicaid funding and modify the program’s structure. For instance, the “One Big Beautiful Bill Act,” enacted in 2025, is estimated to reduce federal Medicaid spending by more than $1 trillion over the coming decade. It also enacts work requirements and greater cost-sharing, which may lower funding and coverage for some eligible groups. These adjustments are expected to shift more financial responsibility to individual states and curb federal Medicaid funding growth, even as the program maintains coverage for tens of millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $4,508,344 | 34.8% |
| 2021 | $7,411,354 | 64.4% |
| 2022 | $10,372,838 | 40% |
| 2023 | $20,402,635 | 96.7% |
| 2024 | $21,621,167 | 6% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $21,621,167 | 28.2% |
| 2 | Medicine Services and Procedures | $21,266,781 | 27.7% |
| 3 | Alcohol and Drug Abuse Treatment | $16,362,143 | 21.3% |
| 4 | Procedures / Professional Services | $5,384,505 | 7% |
| 5 | Temporary National Codes (Non-Medicare) | $5,054,208 | 6.6% |
| 6 | Anesthesia | $2,115,936 | 2.8% |
| 7 | National Codes Established for State Medicaid Agencies | $1,323,243 | 1.7% |
| 8 | Ambulance and Other Transport Services and Supplies | $1,256,471 | 1.6% |
| 9 | Dental Services | $844,585 | 1.1% |
| 10 | Surgery | $574,614 | 0.7% |
| 11 | Radiology Procedures | $482,537 | 0.6% |
| 12 | Pathology and Laboratory Procedures | $187,377 | 0.2% |
| 13 | Chemotherapy Drugs | $63,761 | 0.1% |
| 14 | Vision Services | $46,992 | 0.1% |
| 15 | Drugs Administered Other than Oral Method | $34,081 | <0.1% |
| 16 | Durable Medical Equipment | $14,176 | <0.1% |
| 17 | Medical And Surgical Supplies | $7,083 | <0.1% |
| 18 | Prosthetic Procedures | $1,157 | <0.1% |
| 19 | Temporary Codes | $825 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $15,727,210 | 901 |
| 99213 | Office o/p est low 20 min | $1,631,926 | 453 |
| 99443 | $948,138 | 12 | |
| 99215 | Office o/p est hi 40 min | $879,439 | 12 |
| 99205 | Office o/p new hi 60 min | $636,131 | 38 |
| 99284 | Emergency dept visit mod mdm | $555,984 | 151 |
| 99285 | Emergency dept visit hi mdm | $384,047 | 107 |
| 99291 | Critical care first hour | $138,004 | 53 |
| 99347 | Home/res vst est sf mdm 20 | $114,933 | 5 |
| 99283 | Emergency dept visit low mdm | $96,061 | 68 |
| 99204 | Office o/p new mod 45 min | $88,078 | 70 |
| 99366 | Team conf w/pat by hc prof | $81,752 | 6 |
| 99348 | Home/res vst est low mdm 30 | $80,799 | 6 |
| 99442 | $38,676 | 3 | |
| 99212 | Office o/p est sf 10 min | $36,124 | 38 |
| 99394 | Prev visit est age 12-17 | $26,637 | 20 |
| 99393 | Prev visit est age 5-11 | $24,453 | 19 |
| 99281 | Emr dpt vst mayx req phy/qhp | $23,796 | 11 |
| 99391 | Per pm reeval est pat infant | $16,595 | 14 |
| 99441 | $16,088 | 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.
