Windham Medicaid providers received $81,968 in payments for services under the Evaluation and Management category in 2024, U.S. Department of Health and Human Services Medicaid Provider Spending data shows. This was a 14.5% rise compared with 2023, when $71,560 was billed for the same services.
Medicaid is a government health insurance program operated by the states and partly funded by both federal and state governments. It supports low-income families and individuals, the elderly, children, and people living with disabilities, making it one of the significant components of the U.S. health care system.
Since Medicaid funding comes from taxpayers, trends in local billing reflect how public health care funds are spent within the community.
The Evaluation and Management category covers a set of Medicaid services identified by care type, using specific HCPCS and CPT code groupings. In this analysis, billing codes were classified into a single service category per consistent code prefixes and numeric ranges, ensuring related services were evaluated together, with double counting avoided and rankings maintained over time.
Though Medicaid spending rose for several types of services, Evaluation and Management was the third highest category for Medicaid payments in Windham during 2024.
Evaluation and Management placed fifth across all Medicaid payment categories statewide in New Hampshire for the year 2024.
Between 2019 and 2024, Windham’s Medicaid payments linked to Evaluation and Management grew by $2,183, an increase of 2.7%. Periods of heightened growth were noted in both 2023 and 2022.
Evaluation and Management-related Medicaid spending occurred throughout the city, but the majority was concentrated in just a few ZIP codes. In 2024, ZIP code 03087 reported $81,968 in Medicaid payments for Evaluation and Management, comprising 100% of Windham’s payments in this service area.
Within Evaluation and Management, a small number of billing codes represented most Medicaid payments.
Compared with the 14.5% increase for Evaluation and Management in Windham from 2023 to 2024, all Medicaid claim categories in the city together saw a 38.8% change for the same period.
The Centers for Medicare & Medicaid Services reports that combined federal and state Medicaid spending totaled approximately $871.7 billion in fiscal year 2023, making up about 18% of national health expenditures—up from about $613.5 billion in 2019 before the COVID-19 pandemic.
The figure represents near 40% growth in just a few years, driven mainly by increased enrollment and utilization during and following the pandemic.
Recent major federal budget bills during the Trump administration introduced aggressive proposals to trim federal Medicaid funding and restructure the program. Notably, the “One Big Beautiful Bill Act,” enacted in 2025, is set to reduce federal Medicaid spending by over $1 trillion during the next 10 years, with policies such as work requirements and increased cost-sharing that could potentially narrow coverage and reduce funding for affected beneficiaries. These adjustments are expected to shift more of the program’s financial responsibility to the states, further slowing the growth of federal Medicaid spending even as the program continues to provide coverage for millions of people.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $79,785 | -18.3% |
| 2021 | $70,540 | -11.6% |
| 2022 | $59,172 | -16.1% |
| 2023 | $71,559 | 20.9% |
| 2024 | $81,968 | 14.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $734,094 | 75.9% |
| 2 | Medicine Services and Procedures | $115,928 | 12% |
| 3 | Evaluation and Management | $81,968 | 8.5% |
| 4 | Pathology and Laboratory Procedures | $28,187 | 2.9% |
| 5 | Vision Services | $5,833 | 0.6% |
| 6 | Surgery | $570 | 0.1% |
| 7 | Ambulance and Other Transport Services and Supplies | $519 | 0.1% |
| 8 | Radiology Procedures | $175 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99214 | Office o/p est mod 30 min | $52,898 | 23 |
| 99204 | Office o/p new mod 45 min | $15,687 | 13 |
| 99213 | Office o/p est low 20 min | $10,309 | 12 |
| 99203 | Office o/p new low 30 min | $3,073 | 5 |
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.
