HCPCS 99285

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

Evaluation and management Work RVU per service 4.00 (2024 fee schedule)

64,318
100th percentile among 6,471 codes billed · 2024
$1.18B
100th percentile among 6,471 codes billed · 2024
9.0M
99th percentile among 6,471 codes billed · 2024
104
84th percentile among 6,471 codes billed · 2024
384
76th percentile among 6,471 codes billed · 2024
+1.0%
Medicare payment on the code vs 2023; billers +4.8% · 2024

Trend

Medicare payment on the code

$0$1.00B2020: $1.29B paid20202021: $1.37B paid20212022: $1.31B paid20222023: $1.16B paid20232024: $1.18B paid2024$1.18B$0$1.00B2020: $1.29B paid20202021: $1.37B paid20212022: $1.31B paid20222023: $1.16B paid20232024: $1.18B paid2024$1.18B$0$1.00B2020: $1.29B paid20202021: $1.37B paid20212022: $1.31B paid20222023: $1.16B paid20232024: $1.18B paid2024$1.18B$0$1.00B2020: $1.29B paid20202021: $1.37B paid20212022: $1.31B paid20222023: $1.16B paid20232024: $1.18B paid2024$1.18B

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: 60K providers20222023: 61K providers20232024: 64K providers202464K025K50K2020: 59K providers20202021: 59K providers20212022: 60K providers20222023: 61K providers20232024: 64K providers202464K025K50K2020: 59K providers20202021: 59K providers20212022: 60K providers20222023: 61K providers20232024: 64K providers202464K025K50K2020: 59K providers20202021: 59K providers20212022: 60K providers20222023: 61K providers20232024: 64K providers202464K

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
202464,318$1,175,277,457+1%8,984,0621043844.00
202361,347$1,163,836,365-11%8,497,2941043784.00
202260,120$1,310,981,385-4%8,952,8591144014.00
202158,527$1,367,877,121+6%9,121,3531224114.00
202058,816$1,294,974,635first year in data9,187,7791234143.80

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
California5,596$113,894,649847,440114423
Florida4,210$90,569,613667,745112451
New York4,293$79,184,541559,97596369
Texas4,547$73,674,430569,06986348
Pennsylvania3,359$64,720,250496,047114418
Illinois2,684$59,006,034435,285124429
Ohio2,808$50,674,085395,002116351
Michigan2,781$49,516,764370,524104347
New Jersey1,574$38,856,289278,542132501
Massachusetts1,707$37,314,491280,091116477
North Carolina2,278$36,245,581294,166101335
Virginia1,655$32,442,984252,707118400
Georgia1,838$30,459,917234,14287362
Maryland1,158$25,048,016186,199116452
Indiana1,404$24,640,008198,416109371

Not listed: 34 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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ3,969$84,363,825583,781104
Chicago-Naperville-Elgin, IL-IN2,001$46,769,529342,400129
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,454$34,918,769256,876121
Los Angeles-Long Beach-Anaheim, CA1,670$34,314,302253,140124
Detroit-Warren-Dearborn, MI1,326$26,591,498195,920118
Boston-Cambridge-Newton, MA-NH1,117$24,730,874184,422111
Miami-Fort Lauderdale-West Palm Beach, FL1,035$21,667,571154,027104
Dallas-Fort Worth-Arlington, TX1,110$20,493,058157,591106
Washington-Arlington-Alexandria, DC-VA-MD-WV892$17,357,720128,320102
Houston-Pasadena-The Woodlands, TX1,008$16,577,827126,37096
Atlanta-Sandy Springs-Roswell, GA917$15,345,453115,95785
Baltimore-Columbia-Towson, MD704$14,546,001106,774109
Riverside-San Bernardino-Ontario, CA718$14,456,443108,461122
San Francisco-Oakland-Fremont, CA742$13,938,985100,04591
Tampa-St. Petersburg-Clearwater, FL657$13,769,100103,215118

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 2024.

Specialties billing 99285 nationally

Emergency Medicine accounts for 85% of payment for 99285 nationally in 2024, across 27 specialties on claims.

observed calculated calculated calculated calculated calculated
Emergency Medicine43,75268%$998,544,58285%7,469,746171
Physician Assistant10,46016%$77,873,6366.6%698,49267
Nurse Practitioner5,7398.9%$41,261,2603.5%373,38365
Family Practice2,0233.1%$32,011,0412.7%248,854123
Internal Medicine8371.3%$14,032,8391.2%106,537127
General Surgery2310.36%$1,573,6400.13%11,97052
General Practice1080.17%$1,545,6380.13%11,846110
Critical Care (Intensivists)1210.19%$1,045,2890.09%7,74964
Hospitalist1030.16%$1,032,5890.09%7,92277
Neurology2120.33%$846,9110.07%6,25930
Pediatric Medicine430.07%$820,9010.07%6,185144
Osteopathic Manipulative Medicine290.05%$698,0100.06%5,366185
Psychiatry1850.29%$596,6860.05%4,60825
Medical Toxicology330.05%$480,2070.04%3,465105
Cardiology1150.18%$470,5170.04%3,41130

Not listed: 30 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 2024.

Top billers of 99285 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