Lake Oswego Medicaid providers bill $393,485 for Evaluation and Management services in 2024

Medicaid providers in Lake Oswego submitted claims totaling $393,485 for Evaluation and Management services in 2024, according to the U.S. Department of Health and Human Services Medicaid Provider Spending database. This amount represents a 0.2% rise from 2023, when providers billed $392,861 for these services.

Medicaid, administered by the states and jointly funded by federal and state governments, is a public health insurance program serving low-income individuals and families, seniors, children, and people with disabilities. It is among the largest components of the U.S. health care system.

Because Medicaid is financed by taxpayers, fluctuations in local billing for covered services offer insight into how public funds dedicated to health care are disbursed throughout the community.

The “Evaluation and Management” category includes a range of Medicaid-billed services grouped by the nature of care provided. This grouping is standardized using HCPCS and CPT code prefixes and numeric ranges, so services can be compared cohesively without double counting and to enable accurate year-to-year ranking.

Despite growth across several service categories, Evaluation and Management placed third among Medicaid payment categories in Lake Oswego for 2024.

Statewide in Oregon, Evaluation and Management ranked highest in total Medicaid spending for 2024.

Analyzing the five-year span prior to 2024, Medicaid payments toward the Evaluation and Management category in Lake Oswego climbed by $76,678, equating to a 24.2% increase. There were periods of accelerated growth, with significant year-to-year gains in 2021 and 2022.

While Evaluation and Management spending was reported citywide, payments were heavily focused within certain ZIP codes. In 2024, ZIP code 97035 accounted for $359,876 and ZIP code 97034 for $33,608, so that these two ZIP codes made up 100% of all Medicaid payments for this category in Lake Oswego during the year.

Payments within the Evaluation and Management group were largely attributed to a select group of billing codes.

Comparatively, between 2024 and 2023, Medicaid spending for Evaluation and Management in Lake Oswego rose 0.2%, whereas payments across all service categories in the city shifted by 2.1% in the same timeframe.

According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending was around $871.7 billion in fiscal year 2023, representing about 18% of national health expenditures, a sharp jump from $613.5 billion in 2019, prior to the COVID-19 pandemic.

This change marks growth of almost 40% in several years, with much of the rise attributed to increased enrollment and higher use during and following the pandemic period.

Federal budget legislation under the Trump administration has included notable proposals focused on reducing federal Medicaid funding and restructuring the program. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to curtail over $1 trillion in federal Medicaid spending over 10 years and implement measures such as new work requirements and greater cost-sharing. These policies could shrink coverage and financial support for some, likely shifting more Medicaid responsibility to states and slowing the growth of federal spending, even as the program continues to insure tens of millions of Americans.

Note: HCPCS codes are illustrated for context within their respective category. Category sums and rankings here rely on standardized groupings, not individual billing codes.

The data in this article is sourced from the U.S. Department of Health and Human Services Medicaid Provider Spending database. To review the source data, click here.