In 2024, Medicaid providers in Sachse billed $147,040 for services under the Evaluation and Management category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This figure reflects an 82.5% jump from 2023, when providers billed $80,591 for the same service group.
Medicaid, a state-run, jointly federally and state-funded public health insurance program, covers low-income individuals and families, seniors, children, and people with disabilities, making it one of the largest segments of the U.S. health system. More information is available from the Commonwealth Fund.
Because taxpayer funds support Medicaid, variations in local billing show how public health care spending is distributed in each community.
The Evaluation and Management category represents a set of Medicaid services defined by care type, organized by standardized HCPCS and CPT code groupings. In this analysis, each billing code was categorized into a single service group using consistent code prefixes and number ranges, enabling comparisons and rankings while avoiding duplicate counts.
Evaluation and Management was the second-ranked Medicaid payment category in Sachse in 2024, though spending also increased across multiple categories that year.
Statewide in Texas, Evaluation and Management placed third in total Medicaid spending for 2024.
Between 2019 and 2024, Medicaid payments in Sachse for Evaluation and Management services rose by $145,615, or 10,218.6%. The rate of growth accelerated at times, with significant year-on-year jumps noted in 2023 and 2021.
While city-wide spending was distributed across Sachse, the majority of payments were concentrated in just a few ZIP codes. In 2024, ZIP code 75048 accounted for $147,039, making up 100% of Medicaid payments in this category for the city that year.
Within this category, the largest share of Medicaid spending was tied to a small number of individual billing codes.
From 2023 to 2024, local Medicaid payments for Evaluation and Management services in Sachse climbed 82.5%. Citywide, all Medicaid claim categories combined saw a 48.8% rise over the same timeframe.
According to the Centers for Medicare & Medicaid Services, total federal and state Medicaid spending was about $871.7 billion in fiscal year 2023. This represented nearly 18% of national health expenditures and was up from approximately $613.5 billion in 2019, prior to the COVID-19 pandemic.
This growth, roughly 40% over several years, was largely due to expanded enrollment and increased usage during and after the pandemic.
Recent federal budget laws from the Trump administration included plans to reduce federal Medicaid funding and alter its structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over the next 10 years and implement measures such as work requirements and more cost-sharing. These changes could affect coverage for some enrollees and are likely to push greater costs to states, potentially limiting the expansion of federal Medicaid support even as it continues to serve millions of Americans.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,425 | -39.4% |
| 2021 | $7,600 | 433.3% |
| 2022 | $14,656 | 92.9% |
| 2023 | $80,591 | 449.8% |
| 2024 | $147,039 | 82.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Temporary National Codes (Non-Medicare) | $1,430,086 | 79.7% |
| 2 | Evaluation and Management | $147,039 | 8.2% |
| 3 | Procedures / Professional Services | $54,333 | 3% |
| 4 | Ambulance and Other Transport Services and Supplies | $53,578 | 3% |
| 5 | Dental Services | $51,804 | 2.9% |
| 6 | Medicine Services and Procedures | $30,128 | 1.7% |
| 7 | Pathology and Laboratory Procedures | $27,364 | 1.5% |
| 8 | Surgery | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $37,398 | 12 |
| 99214 | Office o/p est mod 30 min | $32,293 | 21 |
| 99391 | Per pm reeval est pat infant | $29,849 | 12 |
| 99392 | Prev visit est age 1-4 | $23,285 | 12 |
| 99383 | Prev visit new age 5-11 | $9,969 | 6 |
| 99382 | Init pm e/m new pat 1-4 yrs | $5,559 | 4 |
| 99381 | Init pm e/m new pat infant | $4,144 | 4 |
| 99283 | Emergency dept visit low mdm | $2,716 | 3 |
| 99393 | Prev visit est age 5-11 | $1,110 | 1 |
| 99212 | Office o/p est sf 10 min | $451 | 1 |
| 99211 | Off/op est may x req phy/qhp | $260 | 4 |
| 99173 | Visual acuity screen | $0 | 12 |
| 99188 | App topical fluoride varnish | $0 | 11 |
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.
