Kenosha Medicaid spending on Evaluation and Management services climbs to $4,880,529 in 2024

In 2024, Medicaid providers in Kenosha billed $4,880,529 for services in the Evaluation and Management category, data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows. This reflected a 6.7% uptick from 2023, when the same service category drew $4,574,686 in claims.

Medicaid is a state-administered, federally and state-funded health insurance program supporting low-income individuals and families, seniors, children, and people with disabilities. It makes up a significant portion of the U.S. health system.

As Medicaid is funded by taxpayers, fluctuations in billing levels at the local level reflect how public healthcare dollars are allocated within a community.

The “Evaluation and Management” designation encompasses multiple Medicaid-billed services categorized by type of care, grouped based on standard HCPCS and CPT codes. Billing codes for this report were mapped to individual service categories using uniform code prefixes and number ranges, which helped consolidate like services, prevent duplicate counts and ensure rankings stayed consistent.

While overall Medicaid spending saw increases in various service categories, Evaluation and Management ranked as the second-highest in total Medicaid payments in Kenosha for 2024.

Statewide in Wisconsin, Evaluation and Management was also the second-largest category by total Medicaid payments in 2024.

From 2019 to 2024, Kenosha’s Medicaid payments in the Evaluation and Management group grew by $2,172,962, marking an 80.3% rise. Accelerated spending occurred during certain years, particularly in 2021 and 2022 with substantial year-over-year increases.

Distribution of Evaluation and Management spending was observed throughout Kenosha, but much of the payment volume was concentrated in a few ZIP codes. ZIP code 53142 recorded $2,231,858, 53143 listed $1,923,586, and 54342 reported $404,558 in 2024. These top 3 ZIP codes represented 93.4% of all local Medicaid Evaluation and Management payments for the year.

Within the category, Medicaid funds were focused on a small subset of billing codes.

Kenosha’s Medicaid spending for Evaluation and Management rose 6.7% from 2023 to 2024, outpacing the 4.6% increase seen across all Medicaid claim categories in the city during that time.

According to the Centers for Medicare & Medicaid Services, total Medicaid spending by state and federal governments reached about $871.7 billion in fiscal year 2023, accounting for around 18% of national health expenditures—an increase from approximately $613.5 billion in 2019 before the COVID-19 pandemic.

This rise equates to roughly 40% growth in a handful of years, largely resulting from higher enrollment and greater usage during and after the pandemic.

Recent federal budget acts approved under the Trump administration proposed major reductions in federal Medicaid funding and broad program changes. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years, adding new work requirements and higher cost-sharing that could curtail coverage for some. These policy shifts aim to send more cost responsibility to states and curb federal funding growth, even as Medicaid continues to provide for tens of millions.

Note: HCPCS codes are included to illustrate the makeup of the category. Totals and ranks for categories in this article derive from standardized groupings rather than from each individual billing code.

All information in this report comes from the U.S. Department of Health and Human Services Medicaid Provider Spending database. Source data is available here.