HCPCS 99305

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

Evaluation and management Work RVU per service 2.35 (2020 fee schedule)

9,593
97th percentile among 6,116 codes billed · 2020
$74M
97th percentile among 6,116 codes billed · 2020
727K
94th percentile among 6,116 codes billed · 2020
40
70th percentile among 6,116 codes billed · 2020
252
73rd percentile among 6,116 codes billed · 2020

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 York937$10,366,82093,03948382
Florida872$7,756,03476,25452286
New Jersey689$5,999,87156,47143262
California614$5,710,40453,17438272
Illinois576$4,599,51445,25141258
Texas625$3,693,56638,54736200
Pennsylvania581$3,549,73835,42936176
Michigan360$3,252,40032,83250322
Ohio444$2,778,15928,63038199
Maryland256$2,245,59321,36548274
Indiana282$2,003,71521,29042226
Massachusetts234$1,944,56518,38444257
Virginia192$1,569,80715,28937310
North Carolina201$1,562,68015,81649259
Tennessee183$1,373,53214,13347265

Not listed: 2 billers with an armed-forces or unknown state code (XX); they are in the national totals.

Not listed: 4 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,256$13,953,852125,54648
Chicago-Naperville-Elgin, IL-IN500$4,348,71542,80844
Los Angeles-Long Beach-Anaheim, CA308$3,394,91431,26641
Miami-Fort Lauderdale-West Palm Beach, FL365$3,167,72730,35754
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD313$2,721,24526,69147
Detroit-Warren-Dearborn, MI235$2,420,93024,38659
Dallas-Fort Worth-Arlington, TX186$1,537,36315,73651
Baltimore-Columbia-Towson, MD146$1,384,54112,98550
Washington-Arlington-Alexandria, DC-VA-MD-WV142$1,299,94912,28541
Boston-Cambridge-Newton, MA-NH133$1,113,25710,56945
Tampa-St. Petersburg-Clearwater, FL118$1,080,51810,91651
Cleveland, OH133$782,9708,33135
Indianapolis-Carmel-Greenwood, IN83$758,4107,91950
Orlando-Kissimmee-Sanford, FL86$697,3037,11146
Atlanta-Sandy Springs-Roswell, GA77$665,9306,64449

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 93 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 99305 nationally

Internal Medicine accounts for 29% of payment for 99305 nationally in 2020, across 30 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine2,84030%$21,426,72929%205,07572
Family Practice2,02521%$13,552,70918%133,67266
Physical Medicine and Rehabilitation6606.9%$10,973,58015%101,180153
Nurse Practitioner1,78519%$10,414,69814%117,78966
Podiatry2732.8%$2,503,5073.4%23,80387
Psychiatry2122.2%$1,930,5222.6%18,23386
Physician Assistant2672.8%$1,869,0922.5%20,52977
Geriatric Medicine2582.7%$1,867,3432.5%18,17070
General Surgery1301.4%$1,075,9791.5%10,07778
Hospitalist1811.9%$971,1581.3%9,37752
Otolaryngology170.18%$850,7631.1%7,909465
Pulmonary Disease1221.3%$769,9371.0%6,91857
General Practice1111.2%$769,1151.0%7,37566
Infectious Disease961.0%$668,6870.90%6,09163
Cardiology1051.1%$574,6320.78%5,28150

Not listed: 31 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 2020.

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