HCPCS 99220

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

Evaluation and management Work RVU per service 3.56 (2021 fee schedule)

29,208
99th percentile among 6,253 codes billed · 2021
$153M
98th percentile among 6,253 codes billed · 2021
1.1M
95th percentile among 6,253 codes billed · 2021
25
52nd percentile among 6,253 codes billed · 2021
104
56th percentile among 6,253 codes billed · 2021
+0.8%
Medicare payment on the code vs 2020; billers -0.6% · 2021

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
Florida2,651$15,301,574107,30027116
California2,180$11,195,25473,3432489
Texas1,921$9,846,26171,48024106
Illinois1,324$7,520,09951,91026113
Maryland814$7,200,43949,79235198
New Jersey881$7,121,86645,23829176
Pennsylvania1,371$6,992,94749,89024107
New York1,174$6,509,63643,25524114
Ohio1,278$6,446,19346,6882698
Michigan1,087$5,336,80937,9642592
Massachusetts967$5,050,60334,03524105
Virginia870$4,610,77032,56425109
Arizona752$4,490,42432,31428126
North Carolina1,034$4,408,14632,5502280
Indiana703$3,416,70426,2452795

Not listed: 5 billers with an armed-forces or unknown state code (AE, AP, ZZ); they are in the national totals.

Not listed: 2 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,245$9,610,10960,71929
Chicago-Naperville-Elgin, IL-IN1,062$5,934,36140,72226
Baltimore-Columbia-Towson, MD509$4,329,53029,52932
Washington-Arlington-Alexandria, DC-VA-MD-WV535$4,094,35628,15333
Miami-Fort Lauderdale-West Palm Beach, FL634$3,752,51225,02527
Los Angeles-Long Beach-Anaheim, CA716$3,661,88823,65425
Boston-Cambridge-Newton, MA-NH625$3,492,02723,51425
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD644$3,352,29122,85522
Phoenix-Mesa-Chandler, AZ540$3,320,56623,92628
Tampa-St. Petersburg-Clearwater, FL562$3,017,41421,59427
Houston-Pasadena-The Woodlands, TX550$3,010,96521,44225
Detroit-Warren-Dearborn, MI555$2,748,02819,23923
Dallas-Fort Worth-Arlington, TX526$2,652,46319,22824
Atlanta-Sandy Springs-Roswell, GA326$1,488,90210,41522
Seattle-Tacoma-Bellevue, WA277$1,432,27010,07925

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 2021.

Specialties billing 99220 nationally

Internal Medicine accounts for 43% of payment for 99220 nationally in 2021, across 24 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine12,29242%$66,393,56543%464,01838
Hospitalist7,10424%$39,239,56426%274,94939
Emergency Medicine2,2527.7%$12,674,1838.3%79,05735
Family Practice2,3528.1%$11,620,8767.6%82,48335
Nurse Practitioner2,0647.1%$10,207,9346.7%83,59841
Physician Assistant1,2874.4%$6,495,1934.2%50,62639
Cardiology6032.1%$2,162,4821.4%15,26825
Neurology2340.80%$948,3300.62%6,67629
Nephrology1570.54%$646,4780.42%4,49529
Interventional Cardiology1720.59%$550,2910.36%3,87623
General Surgery1330.46%$326,2620.21%2,31117
Pulmonary Disease660.23%$281,1790.18%1,99630
Clinical Cardiac Electrophysiology720.25%$268,2630.17%1,87126
Infectious Disease430.15%$201,4400.13%1,40333
Geriatric Medicine580.20%$194,1730.13%1,34423

Not listed: 32 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 2021.

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