HCPCS 99305

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

Evaluation and management Work RVU per service 2.50 (2023 fee schedule)

10,126
97th percentile among 6,405 codes billed · 2023
$95M
98th percentile among 6,405 codes billed · 2023
935K
95th percentile among 6,405 codes billed · 2023
44
71st percentile among 6,405 codes billed · 2023
310
74th percentile among 6,405 codes billed · 2023
+12.5%
Medicare payment on the code vs 2022; billers +6.5% · 2023

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 York935$15,828,469143,70856530
Florida1,031$9,725,64196,02750314
California705$9,455,67188,72447429
New Jersey754$7,987,73575,89856329
Illinois613$6,825,19267,25455360
Texas606$4,172,56243,30139226
Pennsylvania602$4,100,25041,85739217
Maryland323$3,604,85235,06261329
Michigan332$3,076,17931,20754281
Ohio460$3,006,35231,26739225
Massachusetts235$2,402,04023,12353344
Indiana281$2,389,09325,58055252
North Carolina244$1,896,30019,75350266
Virginia206$1,865,63018,84953250
Tennessee195$1,481,71115,66952221

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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,335$20,816,466189,97859
Chicago-Naperville-Elgin, IL-IN531$6,583,70364,70764
Los Angeles-Long Beach-Anaheim, CA384$5,867,01254,89248
Miami-Fort Lauderdale-West Palm Beach, FL427$4,345,50742,10156
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD352$3,368,77333,59349
Dallas-Fort Worth-Arlington, TX202$2,061,64020,91267
Detroit-Warren-Dearborn, MI212$2,055,06920,64954
Baltimore-Columbia-Towson, MD165$1,992,11819,11059
Washington-Arlington-Alexandria, DC-VA-MD-WV191$1,970,50919,23460
Boston-Cambridge-Newton, MA-NH148$1,450,21713,98359
Tampa-St. Petersburg-Clearwater, FL140$1,281,65713,07953
Orlando-Kissimmee-Sanford, FL117$1,011,46410,15645
Atlanta-Sandy Springs-Roswell, GA65$742,2967,78047
St. Louis, MO-IL108$732,4037,75346
Indianapolis-Carmel-Greenwood, IN72$720,0627,69461

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 2023.

Specialties billing 99305 nationally

Internal Medicine accounts for 23% of payment for 99305 nationally in 2023, across 30 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine2,45824%$21,812,11923%207,65984
Nurse Practitioner2,86828%$20,538,61622%227,01279
Family Practice1,78418%$14,909,07216%145,45682
Physical Medicine and Rehabilitation5965.9%$11,707,43912%106,054178
Physician Assistant5075.0%$5,831,6626.1%62,938124
Podiatry3463.4%$4,167,1254.4%38,304111
General Surgery1641.6%$1,727,3431.8%15,75496
Geriatric Medicine1941.9%$1,512,9671.6%14,53275
General Practice1191.2%$1,400,9951.5%13,388113
Psychiatry1411.4%$1,308,7631.4%11,99485
Otolaryngology140.14%$1,196,5961.3%10,785770
Hospitalist1791.8%$1,092,4891.2%10,59159
Infectious Disease750.74%$1,033,3111.1%9,565128
Cardiology910.90%$954,4571.0%8,61395
Pulmonary Disease1041.0%$872,4060.92%7,91276

Not listed: 33 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 2023.

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