HCPCS 99309

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

Evaluation and management Work RVU per service 1.92 (2023 fee schedule)

28,092
99th percentile among 6,405 codes billed · 2023
$924M
100th percentile among 6,405 codes billed · 2023
12.3M
99th percentile among 6,405 codes billed · 2023
204
91st percentile among 6,405 codes billed · 2023
1,577
90th percentile among 6,405 codes billed · 2023
+35.0%
Medicare payment on the code vs 2022; billers +6.9% · 2023

Trend

Medicare payment on the code

$0$500M$1.00B2020: $646M paid20202021: $641M paid20212022: $685M paid20222023: $924M paid20232024: $1.10B paid2024$1.10B$0$500M$1.00B2020: $646M paid20202021: $641M paid20212022: $685M paid20222023: $924M paid20232024: $1.10B paid2024$1.10B$0$500M$1.00B2020: $646M paid20202021: $641M paid20212022: $685M paid20222023: $924M paid20232024: $1.10B paid2024$1.10B$0$500M$1.00B2020: $646M paid20202021: $641M paid20212022: $685M paid20222023: $924M paid20232024: $1.10B paid2024$1.10B

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

Billers

020K2020: 26K providers20202021: 26K providers20212022: 26K providers20222023: 28K providers20232024: 30K providers202430K020K2020: 26K providers20202021: 26K providers20212022: 26K providers20222023: 28K providers20232024: 30K providers202430K020K2020: 26K providers20202021: 26K providers20212022: 26K providers20222023: 28K providers20232024: 30K providers202430K020K2020: 26K providers20202021: 26K providers20212022: 26K providers20222023: 28K providers20232024: 30K providers202430K

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
202430,091$1,101,657,091+19%14,712,8002241,7641.92
202328,092$924,354,236+35%12,273,1252041,5771.92
202226,291$684,784,757+7%10,623,4661861,4601.55
202125,682$640,927,746-1%9,717,5351761,3661.55
202026,044$646,293,211first year in data9,727,6351721,3511.55

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
Florida2,152$96,904,0591,277,4492912,118
New York2,150$89,579,5621,053,9532181,813
California1,787$85,979,8701,024,6192122,334
Texas1,840$64,416,504882,5652441,658
New Jersey1,399$52,459,730634,1832131,714
Pennsylvania1,659$45,413,539601,1211721,249
Illinois1,402$41,313,960535,9901801,345
Maryland755$36,644,195466,5773432,010
Massachusetts837$31,676,389417,0173001,580
Ohio1,449$31,556,423451,2101761,050
Virginia794$29,396,532404,0552571,834
North Carolina899$28,059,921404,0292641,430
Indiana733$25,622,943380,0672841,794
Georgia557$21,413,178301,4922721,983
Tennessee658$19,601,771291,8152681,358

Not listed: 6 billers with an armed-forces or unknown state code (AE, AP, XX, ZZ); 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-NJ2,450$109,754,9441,258,845226
Los Angeles-Long Beach-Anaheim, CA828$42,838,580508,093198
Chicago-Naperville-Elgin, IL-IN1,159$40,557,211528,297209
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD953$33,658,614432,854230
Miami-Fort Lauderdale-West Palm Beach, FL586$24,116,880299,414266
Washington-Arlington-Alexandria, DC-VA-MD-WV515$22,566,079282,906297
Tampa-St. Petersburg-Clearwater, FL393$21,523,521289,118339
Dallas-Fort Worth-Arlington, TX480$21,518,534289,985395
Boston-Cambridge-Newton, MA-NH538$20,414,694266,596284
Baltimore-Columbia-Towson, MD411$19,279,925245,812336
Houston-Pasadena-The Woodlands, TX399$13,215,548176,925236
Orlando-Kissimmee-Sanford, FL274$13,186,705176,092362
Atlanta-Sandy Springs-Roswell, GA275$12,786,199178,529374
Phoenix-Mesa-Chandler, AZ315$10,921,234146,872224
Detroit-Warren-Dearborn, MI456$10,441,528141,586173

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 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 99309 nationally

Nurse Practitioner accounts for 49% of payment for 99309 nationally in 2023, across 38 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner13,75849%$450,407,28549%6,481,843471
Internal Medicine5,11518%$181,479,10120%2,152,408421
Family Practice3,34312%$92,093,91510.0%1,135,260340
Physician Assistant1,8896.7%$60,150,8116.5%852,820451
Physical Medicine and Rehabilitation6602.3%$41,471,4964.5%474,850719
Geriatric Medicine5582.0%$15,141,9461.6%183,017328
Hospitalist4391.6%$11,214,4921.2%134,816307
General Practice2150.77%$11,127,8881.2%132,313615
Psychiatry3741.3%$10,293,8641.1%123,190329
General Surgery1930.69%$9,698,5341.0%111,016575
Pulmonary Disease1750.62%$4,532,4530.49%51,642295
Emergency Medicine1440.51%$4,467,5950.48%57,856402
Cardiology1020.36%$3,016,0540.33%34,084334
Infectious Disease1100.39%$2,865,8500.31%33,683306
Pain Management320.11%$2,338,9260.25%26,954842

Not listed: 27 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 99309 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