HCPCS 99220

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

Evaluation and management Work RVU per service 3.56 (2022 fee schedule)

28,518
99th percentile among 6,326 codes billed · 2022
$144M
98th percentile among 6,326 codes billed · 2022
1.1M
95th percentile among 6,326 codes billed · 2022
24
50th percentile among 6,326 codes billed · 2022
104
56th percentile among 6,326 codes billed · 2022
-5.9%
Medicare payment on the code vs 2021; billers -2.4% · 2022

Trend

Medicare payment on the code

$0$100M2020: $152M paid20202021: $153M paid20212022: $144M paid2022$144M$0$100M2020: $152M paid20202021: $153M paid20212022: $144M paid2022$144M$0$100M2020: $152M paid20202021: $153M paid20212022: $144M paid2022$144M$0$100M2020: $152M paid20202021: $153M paid20212022: $144M paid2022$144M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

Billers

020K2020: 29K providers20202021: 29K providers20212022: 29K providers202229K020K2020: 29K providers20202021: 29K providers20212022: 29K providers202229K020K2020: 29K providers20202021: 29K providers20212022: 29K providers202229K020K2020: 29K providers20202021: 29K providers20212022: 29K providers202229K

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

observed calculated calculated calculated calculated calculated reported
202228,518$144,213,289-6%1,051,915241043.56
202129,208$153,320,802+1%1,081,807251043.56
202029,384$152,136,368first year in data1,055,79924983.56

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

By state

observed calculated calculated calculated calculated calculated
Florida2,615$15,052,783109,26527125
California2,216$11,135,94575,3832589
Texas1,827$9,371,36970,65525104
Maryland816$7,368,64052,42033224
Illinois1,282$6,788,92448,65126107
New Jersey920$6,688,55844,84428159
Pennsylvania1,380$6,528,96148,4892494
New York1,184$6,398,70243,17824112
Ohio1,197$5,614,45641,8322594
Massachusetts952$4,642,02432,0342294
Michigan1,022$4,552,18033,6252485
Arizona760$4,460,63233,13026136
North Carolina955$4,031,37731,0472383
Virginia814$4,005,42029,32424109
Georgia781$3,233,27724,3232280

Not listed: 4 billers with an armed-forces or unknown state code (AA, AP, ZZ); they are in the national totals.

Not listed: 3 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-NJ1,311$9,272,34960,70828
Chicago-Naperville-Elgin, IL-IN1,022$5,476,93538,83826
Baltimore-Columbia-Towson, MD516$4,500,51331,70133
Los Angeles-Long Beach-Anaheim, CA763$3,869,33125,91026
Miami-Fort Lauderdale-West Palm Beach, FL651$3,856,83326,47428
Washington-Arlington-Alexandria, DC-VA-MD-WV524$3,827,08627,21731
Phoenix-Mesa-Chandler, AZ568$3,457,44225,75428
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD672$3,356,13823,86922
Boston-Cambridge-Newton, MA-NH616$3,102,60621,35623
Tampa-St. Petersburg-Clearwater, FL534$2,892,03021,41027
Houston-Pasadena-The Woodlands, TX505$2,678,27719,85025
Dallas-Fort Worth-Arlington, TX505$2,574,32119,28025
Detroit-Warren-Dearborn, MI494$2,381,13117,23824
Seattle-Tacoma-Bellevue, WA302$1,424,26710,28726
Atlanta-Sandy Springs-Roswell, GA335$1,389,97010,21221

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 2022.

Specialties billing 99220 nationally

Internal Medicine accounts for 42% of payment for 99220 nationally in 2022, across 23 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine11,71641%$61,013,70742%440,84038
Hospitalist7,17425%$38,527,14127%278,55739
Emergency Medicine2,2988.1%$12,064,2758.4%77,22034
Family Practice2,2047.7%$10,489,9967.3%76,70835
Nurse Practitioner2,1737.6%$10,004,5676.9%85,01339
Physician Assistant1,4034.9%$6,658,1014.6%54,05539
Cardiology4701.6%$1,626,7441.1%11,83625
Neurology2130.75%$772,6200.54%5,62926
Nephrology1390.49%$494,1550.34%3,54826
Interventional Cardiology1260.44%$403,6580.28%2,93423
General Surgery1050.37%$288,7220.20%2,04820
Pulmonary Disease540.19%$239,6800.17%1,74032
Clinical Cardiac Electrophysiology620.22%$210,1250.15%1,53025
Infectious Disease440.15%$207,7240.14%1,50634
Geriatric Medicine370.13%$158,6610.11%1,13331

Not listed: 33 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 99220 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