HCPCS 99284

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

Evaluation and management Work RVU per service 2.74 (2023 fee schedule)

64,306
100th percentile among 6,405 codes billed · 2023
$423M
99th percentile among 6,405 codes billed · 2023
4.8M
98th percentile among 6,405 codes billed · 2023
60
78th percentile among 6,405 codes billed · 2023
185
66th percentile among 6,405 codes billed · 2023
+16.5%
Medicare payment on the code vs 2022; billers +6.3% · 2023

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
California5,664$34,813,337388,23353183
Florida3,982$29,929,336322,83761212
New York4,383$29,559,790302,49655175
Texas4,619$26,461,178302,58451169
Pennsylvania3,345$23,186,778260,08564189
Illinois2,670$19,432,337213,55667189
Michigan2,781$17,888,833197,19261158
Ohio2,859$17,459,856200,88560164
North Carolina2,185$13,050,960154,66758173
New Jersey1,560$12,010,538126,39364210
Virginia1,652$11,407,735131,09271179
Massachusetts1,666$11,368,158125,52762184
South Carolina1,170$10,613,474122,26497222
Georgia1,843$10,546,293120,87954162
Maryland1,212$9,051,95399,93565215

Not listed: 29 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ4,070$29,442,007292,52256
Chicago-Naperville-Elgin, IL-IN1,952$13,795,203149,86764
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,503$11,775,347125,89266
Los Angeles-Long Beach-Anaheim, CA1,748$9,695,313106,76547
Detroit-Warren-Dearborn, MI1,367$8,601,00992,61457
Miami-Fort Lauderdale-West Palm Beach, FL979$7,008,56172,46656
Boston-Cambridge-Newton, MA-NH1,056$6,604,37772,28555
Dallas-Fort Worth-Arlington, TX1,089$6,287,14271,26755
Washington-Arlington-Alexandria, DC-VA-MD-WV895$6,224,47667,91865
Baltimore-Columbia-Towson, MD756$5,301,15858,11859
Houston-Pasadena-The Woodlands, TX1,025$4,919,93054,71240
San Francisco-Oakland-Fremont, CA706$4,762,99851,47357
Atlanta-Sandy Springs-Roswell, GA896$4,710,86053,02950
Phoenix-Mesa-Chandler, AZ734$4,329,13550,05652
Minneapolis-St. Paul-Bloomington, MN-WI785$4,092,27448,05554

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 2023.

Specialties billing 99284 nationally

Emergency Medicine accounts for 75% of payment for 99284 nationally in 2023, across 29 specialties on claims.

observed calculated calculated calculated calculated calculated
Emergency Medicine41,77365%$315,300,38975%3,427,84082
Physician Assistant11,06717%$49,980,70012%647,68759
Nurse Practitioner6,2869.8%$27,891,1606.6%365,20158
Family Practice2,2983.6%$16,905,9974.0%190,57783
Internal Medicine8801.4%$6,345,1801.5%69,52679
General Surgery4490.70%$1,226,1490.29%13,29830
General Practice1500.23%$877,4580.21%9,67565
Psychiatry2350.37%$620,1910.15%6,62928
Neurology1650.26%$442,0380.10%4,59128
Hospitalist840.13%$404,6310.10%4,48353
Cardiology1690.26%$396,5640.09%4,11724
Critical Care (Intensivists)960.15%$294,6640.07%3,18733
Osteopathic Manipulative Medicine360.06%$291,0640.07%3,19489
Pediatric Medicine450.07%$276,1210.07%3,04568
Orthopedic Surgery820.13%$221,9400.05%2,27928

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 2023.

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