HCPCS 99305

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

Evaluation and management Work RVU per service 2.35 (2021 fee schedule)

9,404
97th percentile among 6,253 codes billed · 2021
$80M
97th percentile among 6,253 codes billed · 2021
790K
94th percentile among 6,253 codes billed · 2021
43
71st percentile among 6,253 codes billed · 2021
291
74th percentile among 6,253 codes billed · 2021
+8.7%
Medicare payment on the code vs 2020; billers -2.0% · 2021

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 York944$11,928,701105,44352399
Florida895$8,110,22480,23952314
California607$7,028,86965,92143330
New Jersey724$6,975,47465,87045308
Illinois548$5,309,88452,44345318
Pennsylvania562$3,809,83938,36438235
Texas580$3,481,79536,34237203
Michigan325$3,284,60033,24553362
Maryland254$2,772,50326,58059335
Ohio402$2,730,72828,29741212
Massachusetts231$2,215,60521,18947305
Indiana250$2,119,39522,73055278
Virginia213$1,884,80218,51241329
North Carolina215$1,571,72916,14942239
Connecticut178$1,551,74514,88546330

Not listed: 3 billers with an armed-forces or unknown state code (AE, 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,293$16,036,111143,14551
Chicago-Naperville-Elgin, IL-IN474$5,048,79649,78849
Los Angeles-Long Beach-Anaheim, CA309$4,270,39339,97543
Miami-Fort Lauderdale-West Palm Beach, FL377$3,338,35532,20055
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD334$3,076,63730,37052
Detroit-Warren-Dearborn, MI209$2,334,94923,43957
Baltimore-Columbia-Towson, MD137$1,647,67215,73272
Dallas-Fort Worth-Arlington, TX186$1,512,52515,57347
Washington-Arlington-Alexandria, DC-VA-MD-WV139$1,347,41112,68847
Boston-Cambridge-Newton, MA-NH137$1,285,93912,29447
Tampa-St. Petersburg-Clearwater, FL121$1,175,78912,04147
Indianapolis-Carmel-Greenwood, IN72$804,8118,55068
Orlando-Kissimmee-Sanford, FL88$797,3378,07462
Cleveland, OH110$725,9437,69338
St. Louis, MO-IL107$651,7316,84743

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 94 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 99305 nationally

Internal Medicine accounts for 27% of payment for 99305 nationally in 2021, across 32 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine2,60228%$21,395,37627%205,30079
Family Practice1,94421%$13,894,24817%138,02571
Nurse Practitioner1,96921%$12,278,41515%138,02670
Physical Medicine and Rehabilitation6406.8%$12,130,27215%111,340174
Podiatry2963.1%$3,372,6814.2%31,483106
Physician Assistant3013.2%$2,757,9753.4%29,74899
Geriatric Medicine2272.4%$1,866,7472.3%18,19580
Psychiatry1852.0%$1,745,3882.2%16,16687
General Surgery1321.4%$1,273,5841.6%11,81890
Otolaryngology140.15%$1,193,7431.5%10,977784
Hospitalist1761.9%$1,006,1691.3%9,84756
General Practice1081.1%$916,3521.1%8,82482
Cardiology1041.1%$718,1950.89%6,49762
Infectious Disease700.74%$705,6790.88%6,43792
Pulmonary Disease1031.1%$703,1350.87%6,39362

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 2021.

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