In 2024, Medicaid providers in Pearl billed $386,330 for Evaluation and Management services, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show. This total was up 1.2% from 2023, when providers submitted $381,818 in claims for the same service category.
Medicaid, a public health insurance program operated by states with both federal and state funding, covers low-income individuals and families, seniors, children, and people with disabilities, making it a core part of the U.S. health care landscape. More details are available from the Commonwealth Fund.
Since Medicaid funding is sourced from taxpayers, shifts in local billing levels reflect how publicly funded health care resources are distributed within communities.
The Evaluation and Management category includes various Medicaid-billed services defined by type of care, using standardized HCPCS and CPT code groupings. For this report, each billing code was placed into a unique service category based on consistent prefixes and numeric ranges, allowing for accurate analysis and comparisons over time without duplicate counts.
Among Medicaid service categories, Evaluation and Management had the largest payment total in Pearl in 2024.
Statewide, the Evaluation and Management category was third-largest in total Medicaid payments in Mississippi for the year.
Over the five-year period through 2024, Medicaid payments for Evaluation and Management in Pearl rose by $316,119, a 450.2% increase. Much of the growth occurred during certain periods, with substantial annual increases recorded in 2021 and 2022.
Payment data show that while Evaluation and Management services were billed throughout Pearl, payments were heavily concentrated in a small number of ZIP codes. In 2024, ZIP code 39208 accounted for $386,330 in Medicaid Evaluation and Management payments, representing 100% of category spending in the city for that year.
Within the category, just a few individual billing codes received most of the Medicaid payments in Pearl.
From 2023 to 2024, Medicaid payments for Evaluation and Management in Pearl rose 1.2%, compared with a 1.9% change across all Medicaid claim categories in the city during the same timeframe.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending totaled about $871.7 billion for fiscal year 2023, or approximately 18% of all national health expenditures. This is a significant increase from $613.5 billion in 2019, ahead of the COVID-19 pandemic.
This growth represents an increase of around 40% over several years, largely driven by expanded enrollment and greater utilization during and after the pandemic period.
Recent federal budget laws under the Trump administration have brought forward major proposals to reshape Medicaid, including reducing federal funding and program restructuring. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to reduce federal Medicaid expenditures by over $1 trillion in the next decade. The act introduces measures like work requirements and higher cost-sharing, which could affect coverage and funding for certain beneficiaries. These updates are anticipated to shift additional costs to states while curbing the growth of federal Medicaid support, even as the program continues to cover millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $70,211 | -57.4% |
| 2021 | $213,641 | 204.3% |
| 2022 | $368,796 | 72.6% |
| 2023 | $381,817 | 3.5% |
| 2024 | $386,330 | 1.2% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $386,330 | 21.7% |
| 2 | Medical And Surgical Supplies | $372,454 | 20.9% |
| 3 | Dental Services | $281,792 | 15.8% |
| 4 | Enteral and Parenteral Therapy | $265,242 | 14.9% |
| 5 | Medicine Services and Procedures | $189,544 | 10.7% |
| 6 | Temporary National Codes (Non-Medicare) | $128,821 | 7.2% |
| 7 | Pathology and Laboratory Procedures | $112,683 | 6.3% |
| 8 | Vision Services | $38,342 | 2.2% |
| 9 | Durable Medical Equipment | $2,821 | 0.2% |
| 10 | Procedures / Professional Services | $223 | <0.1% |
| 11 | Surgery | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $208,886 | 71 |
| 99213 | Office o/p est low 20 min | $65,509 | 36 |
| 99392 | Prev visit est age 1-4 | $47,723 | 24 |
| 99391 | Per pm reeval est pat infant | $33,581 | 21 |
| 99393 | Prev visit est age 5-11 | $15,750 | 11 |
| 99204 | Office o/p new mod 45 min | $10,774 | 5 |
| 99381 | Init pm e/m new pat infant | $2,251 | 2 |
| 99203 | Office o/p new low 30 min | $1,229 | 1 |
| 99051 | Med serv eve/wkend/holiday | $623 | 4 |
| 99406 | Behav chng smoking 3-10 min | $0 | 4 |
Note: HCPCS codes are included for context within the category. Totals and rankings referenced are based on standardized groupings rather than individual codes.
Information for this article comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The original source data are available here.
