HCPCS 99284

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

Evaluation and management Work RVU per service 2.74 (2021 fee schedule)

59,298
100th percentile among 6,253 codes billed · 2021
$368M
99th percentile among 6,253 codes billed · 2021
3.9M
98th percentile among 6,253 codes billed · 2021
52
76th percentile among 6,253 codes billed · 2021
166
66th percentile among 6,253 codes billed · 2021
+5.6%
Medicare payment on the code vs 2020; billers -0.3% · 2021

Trend

Medicare payment on the code

$0$200M$400M2020: $348M paid20202021: $368M paid20212022: $363M paid20222023: $423M paid20232024: $375M paid2024$375M$0$200M$400M2020: $348M paid20202021: $368M paid20212022: $363M paid20222023: $423M paid20232024: $375M paid2024$375M$0$200M$400M2020: $348M paid20202021: $368M paid20212022: $363M paid20222023: $423M paid20232024: $375M paid2024$375M$0$200M$400M2020: $348M paid20202021: $368M paid20212022: $363M paid20222023: $423M paid20232024: $375M paid2024$375M

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

Billers

025K50K2020: 59K providers20202021: 59K providers20212022: 61K providers20222023: 64K providers20232024: 65K providers202465K025K50K2020: 59K providers20202021: 59K providers20212022: 61K providers20222023: 64K providers20232024: 65K providers202465K025K50K2020: 59K providers20202021: 59K providers20212022: 61K providers20222023: 64K providers20232024: 65K providers202465K025K50K2020: 59K providers20202021: 59K providers20212022: 61K providers20222023: 64K providers20232024: 65K providers202465K

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
202465,448$374,843,174-11%4,389,227531702.74
202364,306$423,199,423+16%4,773,623601852.74
202260,502$363,363,427-1%3,909,961501652.74
202159,298$368,046,210+6%3,899,328521662.74
202059,468$348,455,248first year in data3,888,994511662.60

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
California4,898$27,104,424279,42544142
New York3,984$26,477,691248,53848163
Pennsylvania3,153$22,143,491234,19558188
Texas4,190$21,136,984229,15742139
Florida3,541$19,928,817204,15345146
Illinois2,510$17,462,752179,01458175
Michigan2,592$15,889,139164,62254144
Ohio2,576$15,551,678167,77455150
Massachusetts1,549$13,490,490138,17173225
North Carolina2,055$12,700,864141,68057170
Virginia1,515$9,524,431103,62660153
New Jersey1,463$9,482,35993,87954151
Maryland1,175$8,883,56591,09859205
South Carolina1,049$8,274,08891,72870212
Georgia1,695$8,013,18287,76342123

Not listed: 24 billers with an armed-forces or unknown state code (AA, 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-NJ3,631$25,279,404229,39048
Chicago-Naperville-Elgin, IL-IN1,829$12,364,309124,62056
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,489$10,477,201105,36755
Boston-Cambridge-Newton, MA-NH973$7,940,21580,98466
Detroit-Warren-Dearborn, MI1,278$7,826,29979,15853
Los Angeles-Long Beach-Anaheim, CA1,448$6,922,90270,71837
Washington-Arlington-Alexandria, DC-VA-MD-WV838$5,358,84155,17855
Baltimore-Columbia-Towson, MD721$5,234,72753,06853
Dallas-Fort Worth-Arlington, TX1,029$5,187,56756,42246
Miami-Fort Lauderdale-West Palm Beach, FL883$4,795,01946,64740
San Francisco-Oakland-Fremont, CA620$3,696,61337,48550
Houston-Pasadena-The Woodlands, TX945$3,673,30438,64733
Phoenix-Mesa-Chandler, AZ639$3,443,27036,81443
Atlanta-Sandy Springs-Roswell, GA810$3,425,65336,79835
Minneapolis-St. Paul-Bloomington, MN-WI716$3,270,08035,72444

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 99284 nationally

Emergency Medicine accounts for 76% of payment for 99284 nationally in 2021, across 29 specialties on claims.

observed calculated calculated calculated calculated calculated
Emergency Medicine39,18666%$278,742,19976%2,852,10273
Physician Assistant9,64416%$39,520,80611%484,31250
Nurse Practitioner5,2528.9%$20,999,1915.7%260,94950
Family Practice2,3604.0%$15,959,5144.3%170,41572
Internal Medicine9281.6%$5,852,2661.6%60,72065
General Surgery4350.73%$1,373,6290.37%14,05032
General Practice1600.27%$851,0490.23%8,84255
Psychiatry2220.37%$667,0160.18%6,92331
Cardiology1900.32%$466,1500.13%4,60524
Neurology1720.29%$415,5380.11%4,11324
Hospitalist790.13%$337,1650.09%3,50844
Critical Care (Intensivists)850.14%$325,5260.09%3,20538
Pediatric Medicine470.08%$279,7470.08%2,85261
Urology280.05%$245,2700.07%2,21079
Osteopathic Manipulative Medicine270.05%$235,6630.06%2,46691

Not listed: 28 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 99284 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