HCPCS 99305

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

Evaluation and management Work RVU per service 2.35 (2022 fee schedule)

9,512
97th percentile among 6,326 codes billed · 2022
$84M
97th percentile among 6,326 codes billed · 2022
850K
95th percentile among 6,326 codes billed · 2022
43
71st percentile among 6,326 codes billed · 2022
302
75th percentile among 6,326 codes billed · 2022
+4.8%
Medicare payment on the code vs 2021; billers +1.1% · 2022

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 York961$14,026,411128,92551481
Florida914$8,442,00786,12151314
New Jersey760$7,795,38875,53350339
California623$7,698,37774,37048410
Illinois556$5,725,43858,01448366
Texas599$3,645,82938,92037214
Pennsylvania542$3,406,38835,25837206
Maryland283$3,232,31831,94566369
Michigan335$2,989,07931,31951329
Ohio419$2,648,93428,09342216
Indiana281$2,427,24226,72056285
Massachusetts234$2,202,60521,70546304
Virginia194$1,923,25419,61952347
North Carolina231$1,512,75116,15641227
Connecticut180$1,490,02914,50940283

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

Not listed: 5 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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,331$18,638,773172,33552
Chicago-Naperville-Elgin, IL-IN490$5,688,49457,49854
Los Angeles-Long Beach-Anaheim, CA332$4,791,61746,19646
Miami-Fort Lauderdale-West Palm Beach, FL365$3,289,48032,57252
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD335$2,930,67029,84648
Detroit-Warren-Dearborn, MI219$2,082,89121,56954
Baltimore-Columbia-Towson, MD143$1,799,70117,79274
Dallas-Fort Worth-Arlington, TX203$1,632,31117,05047
Washington-Arlington-Alexandria, DC-VA-MD-WV167$1,627,96215,80942
Tampa-St. Petersburg-Clearwater, FL136$1,294,95913,74753
Boston-Cambridge-Newton, MA-NH138$1,220,82712,06043
Orlando-Kissimmee-Sanford, FL102$903,9399,51254
Indianapolis-Carmel-Greenwood, IN74$775,0468,51364
Cleveland, OH104$669,8707,23442
St. Louis, MO-IL98$610,3296,64341

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 89 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2022.

Specialties billing 99305 nationally

Internal Medicine accounts for 25% of payment for 99305 nationally in 2022, across 29 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine2,47626%$21,223,47525%208,13584
Nurse Practitioner2,35925%$15,137,11318%173,35373
Family Practice1,77819%$13,429,55816%135,81276
Physical Medicine and Rehabilitation6316.6%$12,273,03515%114,541182
Physician Assistant3854.0%$4,338,7765.1%47,375123
Podiatry3173.3%$3,480,9744.1%33,369105
Geriatric Medicine2202.3%$1,606,6411.9%15,96773
Psychiatry1591.7%$1,531,4111.8%14,40091
General Surgery1381.5%$1,329,4361.6%12,55991
General Practice1131.2%$1,098,2801.3%10,83896
Otolaryngology120.13%$1,035,1151.2%9,776815
Pulmonary Disease991.0%$874,4501.0%8,18983
Cardiology991.0%$861,5031.0%8,01881
Hospitalist1511.6%$860,8401.0%8,63657
Infectious Disease840.88%$814,4270.97%7,61991

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 2022.

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