Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database show that Medicaid providers in Coos Bay billed $5,284,881 in 2024 for Evaluation and Management category services. This amount is a 24.5% rise from 2023, when providers submitted $4,244,660 for the same service category.
Medicaid, a public health insurance initiative managed by states and funded through both federal and state resources, serves low-income individuals and families, seniors, children, and those with disabilities, making it a central component of the U.S. health care system.
Because Medicaid funds are sourced from taxpayers, changes in local billing volumes indicate how public health care funding is distributed within a community.
The “Evaluation and Management” category includes Medicaid-billed services defined by care type, structured according to standardized HCPCS and CPT code groupings. Each billing code was categorized to a single service group using uniform code prefixes and number ranges for this analysis, which enabled examination of related services, avoided duplicate counting, and allowed for accurate rankings over time.
Evaluation and Management was the top Medicaid payment category in Coos Bay in 2024, even with overall Medicaid spending increases across multiple service groups.
This category also ranked first for total Medicaid payments statewide in Oregon during 2024.
Over the five-year period leading up to 2024, Medicaid payments in the Evaluation and Management group in Coos Bay rose by $1,781,836, or 50.9%. The pace of spending increased at certain times, with notable year-over-year jumps in both 2023 and 2021.
Although payments for Evaluation and Management care were spread throughout the city, they were focused in a small number of ZIP codes. In 2024, ZIP code 97420 accounted for $5,284,881, representing 100% of all Medicaid payments in the Evaluation and Management category for Coos Bay that year.
Most Medicaid payments within Evaluation and Management were tied to a select few billing codes.
Comparing years, between 2024 and 2023, Medicaid payments in this category for Coos Bay went up by 24.5%, whereas all Medicaid claim categories in the city increased by 3.9% over the same period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid expenditures in fiscal 2023 totaled about $871.7 billion, or approximately 18% of all national health spending, an increase from roughly $613.5 billion in 2019, before the onset of COVID-19.
The change represents growth of about 40% over just a few years, driven primarily by higher enrollment and increased usage during and after the pandemic.
Federal budget measures enacted during the Trump administration have included proposals that significantly reduce federal Medicaid funding and alter the program’s structure. For instance, the “One Big Beautiful Bill Act,” signed into law in 2025, is expected to cut over $1 trillion in federal Medicaid expenditures over the coming decade and includes changes such as work requirements and greater cost-sharing. These moves could reduce both Medicaid coverage and federal support for some recipients, shifting more financial responsibility to states while the program continues to serve millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $3,503,044 | -1.1% |
| 2021 | $3,754,216 | 7.2% |
| 2022 | $3,529,606 | -6% |
| 2023 | $4,244,659 | 20.3% |
| 2024 | $5,284,881 | 24.5% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $5,284,881 | 45.8% |
| 2 | Medicine Services and Procedures | $2,332,372 | 20.2% |
| 3 | Ambulance and Other Transport Services and Supplies | $713,243 | 6.2% |
| 4 | National Codes Established for State Medicaid Agencies | $711,605 | 6.2% |
| 5 | Pathology and Laboratory Procedures | $527,185 | 4.6% |
| 6 | Medical And Surgical Supplies | $406,481 | 3.5% |
| 7 | Durable Medical Equipment | $344,367 | 3% |
| 8 | Radiology Procedures | $320,791 | 2.8% |
| 9 | Surgery | $301,053 | 2.6% |
| 10 | Procedures / Professional Services | $208,709 | 1.8% |
| 11 | Alcohol and Drug Abuse Treatment | $197,197 | 1.7% |
| 12 | Dental Services | $113,980 | 1% |
| 13 | Temporary Codes | $75,254 | 0.7% |
| 14 | Anesthesia | $4,453 | <0.1% |
| 15 | Drugs Administered Other than Oral Method | $1,353 | <0.1% |
| 16 | Durable medical equipment (DME) Medicare administrative contractors (MACs) | $987 | <0.1% |
| 17 | Hearing Services | $965 | <0.1% |
| 18 | Administrative, Miscellaneous and Investigational | $54 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 99284 | Emergency dept visit mod mdm | $1,141,243 | 240 |
| 99285 | Emergency dept visit hi mdm | $954,347 | 191 |
| 99214 | Office o/p est mod 30 min | $869,783 | 540 |
| 99213 | Office o/p est low 20 min | $783,358 | 478 |
| 99283 | Emergency dept visit low mdm | $689,596 | 97 |
| 99203 | Office o/p new low 30 min | $145,608 | 85 |
| 99282 | Emergency dept visit sf mdm | $136,335 | 56 |
| 99233 | Sbsq hosp ip/obs high 50 | $98,401 | 40 |
| 99204 | Office o/p new mod 45 min | $78,151 | 42 |
| 99232 | Sbsq hosp ip/obs moderate 35 | $77,173 | 40 |
| 99223 | 1st hosp ip/obs high 75 | $71,251 | 31 |
| 99239 | Hosp ip/obs dschrg mgmt >30 | $52,264 | 44 |
| 99215 | Office o/p est hi 40 min | $41,525 | 48 |
| 99205 | Office o/p new hi 60 min | $26,510 | 7 |
| 99212 | Office o/p est sf 10 min | $26,295 | 43 |
| 99291 | Critical care first hour | $21,252 | 9 |
| 99442 | $14,771 | 11 | |
| 99392 | Prev visit est age 1-4 | $10,846 | 54 |
| 99391 | Per pm reeval est pat infant | $9,779 | 43 |
| 99238 | Hosp ip/obs dschrg mgmt 30/< | $9,348 | 8 |
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.