Evaluation and Management Medicaid payments in Kalaheo climb 23.2% in 2024

In Kalaheo, Medicaid providers billed a total of $43,511 for Evaluation and Management services in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure represents a 23.2% rise from 2023, when $35,327 was billed for these types of services.

Medicaid operates as a state-run health insurance program financed through both federal and state government contributions. It serves low-income groups, seniors, children, and individuals with disabilities, making it one of the country’s largest health care programs.

Because taxpayer funding supports Medicaid payments, fluctuations in local billing amounts illustrate how public health care resources are distributed within a community.

The “Evaluation and Management” grouping encompasses Medicaid services organized by care type, based on recognized HCPCS and CPT code parameters. Each billing code in this analysis was linked to a single service group using systematic code prefixes and numerical spans. This approach helps group related services for comparison, without overlap, while maintaining reliable ranking over time.

Among Kalaheo’s Medicaid service categories, Evaluation and Management held the top position by total payments in 2024.

Evaluation and Management also ranked first statewide in Hawaii by total Medicaid disbursements in 2024.

From five years prior to 2024, Medicaid payments in Kalaheo for Evaluation and Management services grew by $43,511, equating to 0%. Certain intervals saw especially strong annual growth, notably during 2021 and 2022.

Medicaid spending tied to Evaluation and Management was dispersed throughout the city, but was predominantly concentrated within a small number of ZIP codes. In 2024, ZIP code 96741 accounted for $43,510, representing 100% of all Medicaid payments for this category in Kalaheo that year.

Within the Evaluation and Management group, a few billing codes represented the majority of paid claims.

To provide perspective, the 23.2% increase for Evaluation and Management services in Kalaheo between 2024 and 2023 was greater than the 5.8% change seen across all Medicaid service categories in the city for the same period.

Centers for Medicare & Medicaid Services data shows that combined federal and state Medicaid expenditures reached approximately $871.7 billion in fiscal year 2023. This comprised close to 18% of all U.S. health spending, a significant jump from roughly $613.5 billion in 2019, prior to the COVID-19 emergency.

This amounts to an increase of about 40% in just a few years, largely resulting from greater enrollment and increased service usage during and after the pandemic.

Recent federal budget acts passed under the Trump administration brought forward major changes intended to cut federal Medicaid spending and restructure the program. For instance, the “One Big Beautiful Bill Act,” signed in 2025, is anticipated to reduce federal Medicaid support by more than $1 trillion over the next ten years. The law includes new work requirements and higher cost-sharing, which could lead to reduced coverage and funding for certain enrollees. These measures are expected to push more fiscal responsibility to the states and may restrain future federal Medicaid growth, even as the program continues to provide services to tens of millions of Americans.

Note: HCPCS codes are listed for reference within the category. Totals and rankings in this article are determined using standardized service groups, not individual codes.

Details in this article were sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Access the original data here.