In 2024, Medicaid providers in Dearborn Heights billed $8,249,785 for Evaluation and Management services, based on figures from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents an 8.1% increase from 2023 when claims for those same services reached $7,632,854.
Medicaid is a state-operated public health insurance program funded jointly by federal and state governments. The program provides coverage to low-income individuals and families, seniors, children, and people living with disabilities, making it a significant component of the U.S. health care system.
Since Medicaid is financed by taxpayer contributions, local changes in billing patterns illustrate how public health care funds are distributed within communities.
The “Evaluation and Management” group consists of Medicaid-billed services grouped by care type, using standardized HCPCS and CPT coding. Each billing code was attributed to just one service category for this analysis, employing set code prefixes and ranges to ensure closely related services are examined together and to avoid double counting, supporting accurate comparisons over time.
Spending on Medicaid increased in several service groupings; however, Evaluation and Management received the highest amount of Medicaid payments in Dearborn Heights for 2024.
Across Michigan, Evaluation and Management was the third largest category by Medicaid payment total in 2024.
Over the five-year span prior to 2024, Medicaid payments for the Evaluation and Management grouping in Dearborn Heights saw an increase of $4,903,988, or 146.6%. Growth in spending sped up during some periods, notably with year-over-year surges in both 2021 and 2022.
While claims for Evaluation and Management services occurred throughout the city, the bulk of payments came from a small number of ZIP codes. For 2024, ZIP code 48127 generated $7,446,789, and ZIP code 48125 accounted for $802,994; together, these two areas represented 100% of Dearborn Heights’ Medicaid payments for this category that year.
Payment distribution within the Evaluation and Management grouping was similarly concentrated among just a handful of individual billing codes.
When compared with an overall 4.5% jump across all Medicaid claim categories in the city during the same time frame, the 8.1% increase for Evaluation and Management services in Dearborn Heights between 2024 and 2023 stands out.
The Centers for Medicare & Medicaid Services reports that total federal and state Medicaid spending totaled roughly $871.7 billion in fiscal 2023, about 18% of total national health expenses, which is a major rise from the pre-pandemic figure of $613.5 billion in 2019.
This reflects about a 40% surge within several years, mainly due to increased enrollment and service use during and following the pandemic.
Recent federal budget actions under the Trump administration include substantial proposals targeting federal Medicaid funding reductions and structural program changes. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to result in over $1 trillion in Medicaid federal spending reductions and introduces requirements such as work mandates and additional cost sharing, which may decrease funding and coverage for certain recipients. These measures are likely to increase state financial responsibility for Medicaid, slowing growth in federal support while the program continues to aid tens of millions of individuals nationwide.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $3,345,796 | -4.2% |
| 2021 | $5,181,820 | 54.9% |
| 2022 | $6,325,453 | 22.1% |
| 2023 | $7,632,854 | 20.7% |
| 2024 | $8,249,784 | 8.1% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $8,249,784 | 70.5% |
| 2 | Medicine Services and Procedures | $900,062 | 7.7% |
| 3 | Dental Services | $866,592 | 7.4% |
| 4 | Pathology and Laboratory Procedures | $417,480 | 3.6% |
| 5 | Ambulance and Other Transport Services and Supplies | $384,426 | 3.3% |
| 6 | Drugs Administered Other than Oral Method | $302,253 | 2.6% |
| 7 | Surgery | $259,562 | 2.2% |
| 8 | Alcohol and Drug Abuse Treatment | $197,059 | 1.7% |
| 9 | Radiology Procedures | $74,154 | 0.6% |
| 10 | National Codes Established for State Medicaid Agencies | $12,661 | 0.1% |
| 11 | Chemotherapy Drugs | $11,708 | 0.1% |
| 12 | Temporary National Codes (Non-Medicare) | $6,588 | 0.1% |
| 13 | Temporary Codes | $6,056 | 0.1% |
| 14 | Coronavirus Diagnostic Panel | $4,078 | <0.1% |
| 15 | Vision Services | $3,156 | <0.1% |
| 16 | Medical And Surgical Supplies | $2 | <0.1% |
| 17 | Procedures / Professional Services | $2 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99213 | Office o/p est low 20 min | $2,898,567 | 226 |
| 99214 | Office o/p est mod 30 min | $2,692,273 | 209 |
| 99204 | Office o/p new mod 45 min | $396,736 | 67 |
| 99203 | Office o/p new low 30 min | $240,604 | 74 |
| 99392 | Prev visit est age 1-4 | $234,382 | 33 |
| 99395 | Prev visit est age 18-39 | $214,199 | 80 |
| 99402 | Prev med cnsl indiv apprx 30 | $205,677 | 12 |
| 99393 | Prev visit est age 5-11 | $199,063 | 34 |
| 99396 | Prev visit est age 40-64 | $167,536 | 72 |
| 99391 | Per pm reeval est pat infant | $140,247 | 26 |
| 99215 | Office o/p est hi 40 min | $127,687 | 24 |
| 99394 | Prev visit est age 12-17 | $99,114 | 30 |
| 99385 | Prev visit new age 18-39 | $81,609 | 39 |
| 99490 | Chrnc care mgmt staff 1st 20 | $64,730 | 12 |
| 99386 | Prev visit new age 40-64 | $54,565 | 26 |
| 99232 | Sbsq hosp ip/obs moderate 35 | $44,555 | 9 |
| 99212 | Office o/p est sf 10 min | $39,410 | 47 |
| 99487 | Cplx chrnc care 1st 60 min | $36,803 | 12 |
| 99426 | Prin care mgmt staff 1st 30 | $33,158 | 12 |
| 99205 | Office o/p new hi 60 min | $30,485 | 10 |
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.
