HCPCS 99305

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

Evaluation and management Work RVU per service 2.50 (2024 fee schedule)

10,676
97th percentile among 6,471 codes billed · 2024
$101M
98th percentile among 6,471 codes billed · 2024
1.0M
96th percentile among 6,471 codes billed · 2024
46
70th percentile among 6,471 codes billed · 2024
323
74th percentile among 6,471 codes billed · 2024
+6.4%
Medicare payment on the code vs 2023; billers +5.4% · 2024

Trend

Medicare payment on the code

$0$50M$100M2020: $74M paid20202021: $80M paid20212022: $84M paid20222023: $95M paid20232024: $101M paid2024$101M$0$50M$100M2020: $74M paid20202021: $80M paid20212022: $84M paid20222023: $95M paid20232024: $101M paid2024$101M$0$50M$100M2020: $74M paid20202021: $80M paid20212022: $84M paid20222023: $95M paid20232024: $101M paid2024$101M$0$50M$100M2020: $74M paid20202021: $80M paid20212022: $84M paid20222023: $95M paid20232024: $101M paid2024$101M

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

Billers

05,00010K2020: 9,593 providers20202021: 9,404 providers20212022: 9,512 providers20222023: 10K providers20232024: 11K providers202411K05,00010K2020: 9,593 providers20202021: 9,404 providers20212022: 9,512 providers20222023: 10K providers20232024: 11K providers202411K05,00010K2020: 9,593 providers20202021: 9,404 providers20212022: 9,512 providers20222023: 10K providers20232024: 11K providers202411K05,00010K2020: 9,593 providers20202021: 9,404 providers20212022: 9,512 providers20222023: 10K providers20232024: 11K providers202411K

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
202410,676$100,870,574+6%1,020,750463232.50
202310,126$94,839,375+13%934,508443102.50
20229,512$84,267,808+5%850,079433022.35
20219,404$80,414,004+9%790,311432912.35
20209,593$73,991,683first year in data726,635402522.35

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
New York954$14,853,302139,97358544
Florida1,107$12,178,503123,44358374
California740$10,554,585101,74556472
New Jersey782$8,159,02479,07455326
Illinois636$7,092,36472,79055383
Pennsylvania635$4,557,47147,73543237
Texas632$4,511,48647,94242242
Maryland334$4,146,94741,37573386
Ohio462$3,121,36433,02737258
Michigan333$2,974,47430,55950290
Massachusetts259$2,709,39326,64057335
Indiana311$2,314,93225,68346237
North Carolina282$2,213,99423,54248272
Virginia227$1,809,41518,65950265
Tennessee197$1,624,27617,56865239

Not listed: 3 billers with an armed-forces or unknown state code (AE, XX); 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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,351$19,766,293186,49060
Chicago-Naperville-Elgin, IL-IN551$6,505,70066,47360
Los Angeles-Long Beach-Anaheim, CA423$6,473,17862,70562
Miami-Fort Lauderdale-West Palm Beach, FL446$5,787,98857,17171
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD354$3,450,68635,01156
Dallas-Fort Worth-Arlington, TX228$2,448,04525,69265
Washington-Arlington-Alexandria, DC-VA-MD-WV208$2,205,33822,02956
Baltimore-Columbia-Towson, MD162$2,042,13420,06373
Detroit-Warren-Dearborn, MI206$1,986,14520,29552
Boston-Cambridge-Newton, MA-NH169$1,640,16616,16655
Orlando-Kissimmee-Sanford, FL137$1,481,99915,45046
Tampa-St. Petersburg-Clearwater, FL165$1,470,63915,46050
Atlanta-Sandy Springs-Roswell, GA82$870,9539,28647
St. Louis, MO-IL110$818,1588,99350
Providence-Warwick, RI-MA76$806,4548,28253

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 96 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 99305 nationally

Nurse Practitioner accounts for 26% of payment for 99305 nationally in 2024, across 32 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner3,53933%$25,987,46526%292,62083
Internal Medicine2,32222%$21,128,56821%205,09088
Family Practice1,67916%$14,170,89614%140,53884
Physical Medicine and Rehabilitation5725.4%$11,465,17211%107,429188
Physician Assistant5685.3%$5,866,1865.8%64,632114
Podiatry3723.5%$4,345,5714.3%40,829110
General Surgery1911.8%$2,588,1132.6%24,045126
General Practice1381.3%$1,702,4821.7%16,575120
Geriatric Medicine1811.7%$1,498,8181.5%14,57181
Otolaryngology150.14%$1,300,4511.3%11,955797
Cardiology860.81%$1,268,4061.3%11,684136
Infectious Disease880.82%$1,253,4441.2%11,993136
Hospitalist1781.7%$1,171,5581.2%11,54965
Pulmonary Disease1071.0%$1,006,8191.00%9,32787
Psychiatry1191.1%$993,8550.99%9,53680

Not listed: 29 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 99305 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