HCPCS 99345

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

Evaluation and management Work RVU per service 4.09 (2020 fee schedule)

1,369
88th percentile among 6,116 codes billed · 2020
$8.1M
87th percentile among 6,116 codes billed · 2020
52K
81st percentile among 6,116 codes billed · 2020
23
50th percentile among 6,116 codes billed · 2020
113
59th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$10M$20M2020: $8.1M paid20202021: $8.7M paid20212022: $8.8M paid20222023: $17M paid20232024: $19M paid2024$19M$0$10M$20M2020: $8.1M paid20202021: $8.7M paid20212022: $8.8M paid20222023: $17M paid20232024: $19M paid2024$19M$0$10M$20M2020: $8.1M paid20202021: $8.7M paid20212022: $8.8M paid20222023: $17M paid20232024: $19M paid2024$19M$0$10M$20M2020: $8.1M paid20202021: $8.7M paid20212022: $8.8M paid20222023: $17M paid20232024: $19M paid2024$19M

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

Billers

02,0002020: 1,369 providers20202021: 1,436 providers20212022: 1,470 providers20222023: 3,167 providers20232024: 3,513 providers20243,51302,0002020: 1,369 providers20202021: 1,436 providers20212022: 1,470 providers20222023: 3,167 providers20232024: 3,513 providers20243,51302,0002020: 1,369 providers20202021: 1,436 providers20212022: 1,470 providers20222023: 3,167 providers20232024: 3,513 providers20243,51302,0002020: 1,369 providers20202021: 1,436 providers20212022: 1,470 providers20222023: 3,167 providers20232024: 3,513 providers20243,513

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
20243,513$19,097,598+12%142,639241043.88
20233,167$16,997,800+94%123,773241073.88
20221,470$8,754,680+1%57,804221114.09
20211,436$8,662,140+7%55,774231054.09
20201,369$8,110,701first year in data51,670231134.09

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
California147$1,710,86110,09431251
Texas171$1,022,8216,94326152
New York111$895,9405,07624169
Florida131$683,6514,4732595
Illinois73$565,3643,40323106
New Jersey66$445,4302,69724137
Michigan74$359,5122,3572197
Maryland45$240,4101,5522091
Nevada37$217,6481,49929137
South Carolina57$181,0771,3112043
North Carolina49$168,6591,1851855
Massachusetts33$137,9538942157
Pennsylvania25$135,2198412463
Virginia25$120,1987752686
Arizona25$116,39676318131

Not listed: 20 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-NJ132$1,148,1546,49426
Los Angeles-Long Beach-Anaheim, CA85$1,059,2926,29731
Dallas-Fort Worth-Arlington, TX85$568,9013,83629
Chicago-Naperville-Elgin, IL-IN70$567,9563,41122
Detroit-Warren-Dearborn, MI49$285,4951,83230
Miami-Fort Lauderdale-West Palm Beach, FL35$268,1701,67437
Riverside-San Bernardino-Ontario, CA15$242,9571,40940
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD39$217,7341,36024
Las Vegas-Henderson-North Las Vegas, NV33$206,9621,41431
Baltimore-Columbia-Towson, MD30$157,4621,03622
San Diego-Chula Vista-Carlsbad, CA22$150,18688033
Washington-Arlington-Alexandria, DC-VA-MD-WV29$145,12692616
Houston-Pasadena-The Woodlands, TX34$128,80386825
San Antonio-New Braunfels, TX15$104,45076623
Boston-Cambridge-Newton, MA-NH26$102,97667620

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 26 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 99345 nationally

Nurse Practitioner accounts for 51% of payment for 99345 nationally in 2020, across 7 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner89065%$4,108,89951%28,38732
Internal Medicine17112%$1,287,15716%7,34543
Family Practice1007.3%$931,22611%5,37754
General Practice312.3%$404,2525.0%2,32475
Physician Assistant785.7%$364,8854.5%2,50132
Hospice and Palliative Care141.0%$117,3481.4%63045
Geriatric Medicine181.3%$81,3291.0%48927

Not listed: 23 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 99345 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