HCPCS 90960

Other service (ClaimLight category; the code descriptor is not shown)

Other services Work RVU per service 6.77 (2022 fee schedule)

6,814
96th percentile among 6,326 codes billed · 2022
$390M
99th percentile among 6,326 codes billed · 2022
1.4M
96th percentile among 6,326 codes billed · 2022
168
91st percentile among 6,326 codes billed · 2022
476
80th percentile among 6,326 codes billed · 2022
-18.5%
Medicare payment on the code vs 2021; billers -3.4% · 2022

Trend

Medicare payment on the code

$0$200M$400M2020: $495M paid20202021: $478M paid20212022: $390M paid20222023: $333M paid20232024: $297M paid2024$297M$0$200M$400M2020: $495M paid20202021: $478M paid20212022: $390M paid20222023: $333M paid20232024: $297M paid2024$297M$0$200M$400M2020: $495M paid20202021: $478M paid20212022: $390M paid20222023: $333M paid20232024: $297M paid2024$297M$0$200M$400M2020: $495M paid20202021: $478M paid20212022: $390M paid20222023: $333M paid20232024: $297M paid2024$297M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

05,0002020: 7,360 providers20202021: 7,057 providers20212022: 6,814 providers20222023: 6,549 providers20232024: 6,383 providers20246,38305,0002020: 7,360 providers20202021: 7,057 providers20212022: 6,814 providers20222023: 6,549 providers20232024: 6,383 providers20246,38305,0002020: 7,360 providers20202021: 7,057 providers20212022: 6,814 providers20222023: 6,549 providers20232024: 6,383 providers20246,38305,0002020: 7,360 providers20202021: 7,057 providers20212022: 6,814 providers20222023: 6,549 providers20232024: 6,383 providers20246,383

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
20246,383$296,622,466-11%1,080,7131423966.77
20236,549$333,207,529-15%1,197,6331534276.77
20226,814$390,094,256-18%1,368,4571684766.77
20217,057$478,375,612-3%1,657,3341955726.77
20207,360$495,091,415first year in data2,151,8492397395.18

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
California647$50,205,795166,942226655
Texas645$38,519,446138,702189469
New York465$30,042,25695,796175496
Florida459$24,620,18785,951164445
Illinois298$17,250,79659,638169477
North Carolina255$15,884,37457,990206496
Georgia257$14,896,63753,936179492
Pennsylvania313$14,555,03451,153141352
New Jersey241$14,386,53247,235172444
Maryland162$13,066,21843,630247512
Michigan218$12,179,64043,413179456
Virginia182$10,736,92937,772190405
Ohio251$8,795,84731,832102335
South Carolina134$8,475,93331,121205520
Tennessee137$7,855,59629,554193499

Not listed: 1 billers with an armed-forces or unknown state code (ZZ); they are in the national totals.

Not listed: 6 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ499$31,496,37498,122172
Los Angeles-Long Beach-Anaheim, CA257$20,854,26568,718214
Chicago-Naperville-Elgin, IL-IN253$14,939,07251,489166
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD198$10,595,51335,883162
Dallas-Fort Worth-Arlington, TX191$10,139,96336,152164
Washington-Arlington-Alexandria, DC-VA-MD-WV133$9,887,36332,361218
Houston-Pasadena-The Woodlands, TX160$8,239,10328,838158
Miami-Fort Lauderdale-West Palm Beach, FL132$6,931,48723,530144
Atlanta-Sandy Springs-Roswell, GA133$6,705,94723,888161
Baltimore-Columbia-Towson, MD86$6,463,57321,737249
San Francisco-Oakland-Fremont, CA83$6,126,01219,244223
Detroit-Warren-Dearborn, MI110$5,770,66720,109158
Riverside-San Bernardino-Ontario, CA85$5,158,01517,780210
Boston-Cambridge-Newton, MA-NH80$4,810,90916,187134
San Antonio-New Braunfels, TX76$4,497,51816,489221

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 90 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2022.

Specialties billing 90960 nationally

Nephrology accounts for 89% of payment for 90960 nationally in 2022, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Nephrology5,74384%$346,802,83189%1,214,509211
Internal Medicine5938.7%$35,192,2869.0%123,073208
Nurse Practitioner3304.8%$3,158,8040.81%13,29040
Neurology320.47%$2,005,3950.51%6,933217
Hospitalist220.32%$970,7780.25%3,411155
Physician Assistant640.94%$447,4870.11%1,90930

Not listed: 13 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2022.

Top billers of 90960 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations