HCPCS 99214

Evaluation and management service (ClaimLight category; the code descriptor is not shown)

Evaluation and management Work RVU per service 1.50 (2020 fee schedule)

427,811
100th percentile among 6,116 codes billed · 2020
$6.22B
100th percentile among 6,116 codes billed · 2020
87.6M
100th percentile among 6,116 codes billed · 2020
102
88th percentile among 6,116 codes billed · 2020
737
86th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$5.00B2020: $6.22B paid20202021: $8.41B paid20212022: $8.14B paid20222023: $8.23B paid20232024: $8.43B paid2024$8.43B$0$5.00B2020: $6.22B paid20202021: $8.41B paid20212022: $8.14B paid20222023: $8.23B paid20232024: $8.43B paid2024$8.43B$0$5.00B2020: $6.22B paid20202021: $8.41B paid20212022: $8.14B paid20222023: $8.23B paid20232024: $8.43B paid2024$8.43B$0$5.00B2020: $6.22B paid20202021: $8.41B paid20212022: $8.14B paid20222023: $8.23B paid20232024: $8.43B paid2024$8.43B

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

Billers

0200K400K2020: 428K providers20202021: 449K providers20212022: 463K providers20222023: 480K providers20232024: 498K providers2024498K0200K400K2020: 428K providers20202021: 449K providers20212022: 463K providers20222023: 480K providers20232024: 498K providers2024498K0200K400K2020: 428K providers20202021: 449K providers20212022: 463K providers20222023: 480K providers20232024: 498K providers2024498K0200K400K2020: 428K providers20202021: 449K providers20212022: 463K providers20222023: 480K providers20232024: 498K providers2024498K

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
2024498,045$8,429,417,260+2%102,377,8571077211.92
2023479,517$8,232,146,357+1%99,338,8041077311.92
2022463,447$8,139,871,713-3%97,229,1041077431.92
2021449,158$8,409,089,386+35%96,343,0711097631.92
2020427,811$6,217,850,436first year in data87,626,3871027371.50

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
Florida28,089$627,421,1388,278,9661351,101
California33,103$626,888,3047,820,172107891
Texas27,600$431,945,7126,134,114111790
New York26,892$391,862,8174,805,58888651
Pennsylvania20,918$245,655,0853,514,04193562
Illinois17,049$239,930,5283,338,240104670
North Carolina16,498$235,554,2943,550,965116741
New Jersey11,992$231,205,8472,826,436129808
Virginia11,451$201,531,1272,847,295130874
Georgia12,031$192,465,1232,766,877119838
Maryland9,261$182,243,1652,349,729127903
Ohio17,981$175,195,7082,821,22588533
Massachusetts13,947$170,239,5732,345,94595575
Arizona9,481$169,749,6402,388,726113922
Tennessee10,152$149,503,2872,305,944119771

Not listed: 48 billers with an armed-forces or unknown state code (AA, AE, AP, PW, XX, ZZ); they are in the national totals.

Not listed: 1 state 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ25,037$453,210,1175,220,589101
Los Angeles-Long Beach-Anaheim, CA11,401$211,857,6952,548,726102
Chicago-Naperville-Elgin, IL-IN13,103$184,645,0962,508,588102
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD9,886$142,227,7191,897,199102
Washington-Arlington-Alexandria, DC-VA-MD-WV7,395$135,823,5571,690,337113
Miami-Fort Lauderdale-West Palm Beach, FL7,123$132,621,1361,668,315105
Boston-Cambridge-Newton, MA-NH10,332$114,796,0151,569,82486
Dallas-Fort Worth-Arlington, TX7,832$113,834,9791,585,590106
Phoenix-Mesa-Chandler, AZ6,532$112,984,5151,577,474109
Houston-Pasadena-The Woodlands, TX6,618$90,218,5271,236,42191
Baltimore-Columbia-Towson, MD5,166$88,241,9961,161,773114
Atlanta-Sandy Springs-Roswell, GA6,493$87,690,9521,227,915105
Tampa-St. Petersburg-Clearwater, FL4,512$80,745,7541,089,589126
Detroit-Warren-Dearborn, MI6,163$76,271,8271,061,88393
San Francisco-Oakland-Fremont, CA4,117$64,885,663762,18597

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 99214 nationally

Internal Medicine accounts for 18% of payment for 99214 nationally in 2020, across 70 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine50,06612%$1,103,351,47518%15,445,484309
Family Practice61,31614%$1,031,426,55517%15,293,379249
Cardiology16,9814.0%$579,722,0519.3%7,563,217445
Nurse Practitioner72,38017%$537,978,2568.7%9,209,324127
Physician Assistant38,1578.9%$262,071,6554.2%4,396,274115
Hematology-Oncology7,6711.8%$239,348,3913.8%3,180,091415
Urology7,8801.8%$177,519,2072.9%2,297,966292
Dermatology8,8152.1%$167,212,3842.7%2,237,491254
Neurology10,7972.5%$155,356,4182.5%2,064,749191
Orthopedic Surgery15,0613.5%$151,596,3682.4%1,926,761128
Pulmonary Disease7,7021.8%$146,886,9912.4%1,888,545245
Endocrinology5,4481.3%$140,731,9032.3%1,868,111343
Rheumatology4,4821.0%$128,212,1922.1%1,698,774379
Nephrology7,3871.7%$123,557,5702.0%1,629,808221
Interventional Cardiology3,5920.84%$108,259,7451.7%1,451,197404

Not listed: 10 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 2020.

Top billers of 99214 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