Athens sees $3,161 in Medicaid payments for Evaluation and Management services in 2024, up 343%

In 2024, Athens Medicaid providers billed $3,161 for Evaluation and Management services, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This reflects a 343.3% rise from 2023, when claims for the same service type totaled $713.

Medicaid is a public health insurance initiative operated by states and funded in partnership by federal and state governments. It serves low-income families and individuals, children, seniors, and people with disabilities, making it a core component of the U.S. health care system.

Since taxpayer dollars support Medicaid payments, shifts in local billing levels reveal how public health funding is distributed within the community.

The “Evaluation and Management” category encompasses a group of Medicaid-billed services, determined by the type of care and organized based on standardized HCPCS and CPT code groups. Each billing code was mapped to one service category for this analysis, using consistent code prefixes and ranges, to allow for an accurate look at related services while preventing duplicate counting and ensuring reliable rankings over time.

In addition to increases across other service categories, Evaluation and Management led in Athens by total Medicaid payments in 2024.

Statewide in Wisconsin, the Evaluation and Management category came in second by total payments for 2024.

From five years prior to 2024, Athens saw Medicaid payments for Evaluation and Management services climb by $1,591, or 101.3%. The pace of spending picked up during multiple periods, with notably high year-over-year increases seen in both 2023 and 2022.

While the distribution of Evaluation and Management payments covered a range of areas in the city, most were concentrated within a small set of ZIP codes. In 2024, ZIP code 54411 represented $3,161 of payments, holding 100% of all Athens Medicaid spending in this category for the year.

A small subset of individual billing codes accounted for the majority of Medicaid payments under the Evaluation and Management category.

Comparatively, Athens saw a 343.3% jump in Evaluation and Management Medicaid payments between 2024 and 2023, while overall Medicaid claim categories in the city increased by 57.4% during the same period.

Centers for Medicare & Medicaid Services data show federal and state Medicaid spending reached approximately $871.7 billion in fiscal year 2023, making up about 18% of all national health spending—up sharply from $613.5 billion in 2019 before the COVID-19 emergency.

This jump marks a roughly 40% increase in a span of a few years, largely due to higher enrollment and greater service use throughout and following the pandemic.

Recent federal budget changes during the Trump administration have introduced notable efforts to trim federal Medicaid funding and alter the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to cut federal Medicaid funding by more than $1 trillion during the next decade, implementing policies such as work requirements and expanded cost-sharing. These provisions may reduce coverage and funding for some recipients and are anticipated to shift more costs to states, even as Medicaid continues to cover millions nationwide.

Note: HCPCS codes are provided to contextualize the category. The totals and rankings in this article are based on consolidated service groupings, not individual codes.

The data in this article comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. You can find the original source data here.