HCPCS 99345

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

Evaluation and management Work RVU per service 4.09 (2021 fee schedule)

1,436
88th percentile among 6,253 codes billed · 2021
$8.7M
87th percentile among 6,253 codes billed · 2021
56K
81st percentile among 6,253 codes billed · 2021
23
48th percentile among 6,253 codes billed · 2021
105
57th percentile among 6,253 codes billed · 2021
+6.8%
Medicare payment on the code vs 2020; billers +4.9% · 2021

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
California149$2,073,92512,37026389
Texas187$988,7736,80024103
New York96$920,3665,21633153
Florida158$893,7975,8642492
Illinois72$463,8202,84624112
New Jersey58$369,4832,30728117
Michigan59$333,3822,1322474
North Carolina59$235,1591,6192156
Nevada36$218,2521,52326128
Maryland42$216,6271,4042291
Massachusetts39$188,6931,2682568
Arizona39$176,9861,2611891
Virginia30$158,8351,0352380
Pennsylvania42$142,6579311751
Ohio38$119,4328331839

Not listed: 21 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
Los Angeles-Long Beach-Anaheim, CA89$1,596,0709,52032
New York-Newark-Jersey City, NY-NJ106$1,065,0706,03035
Dallas-Fort Worth-Arlington, TX93$537,7403,69625
Chicago-Naperville-Elgin, IL-IN69$470,3522,88825
Miami-Fort Lauderdale-West Palm Beach, FL45$332,7432,14433
Detroit-Warren-Dearborn, MI37$243,4221,51227
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD52$223,2081,42919
Las Vegas-Henderson-North Las Vegas, NV32$210,7701,46926
Washington-Arlington-Alexandria, DC-VA-MD-WV36$172,3271,10321
Boston-Cambridge-Newton, MA-NH33$156,2081,04523
Phoenix-Mesa-Chandler, AZ28$149,5861,07220
San Diego-Chula Vista-Carlsbad, CA24$149,41587929
Houston-Pasadena-The Woodlands, TX34$141,85193721
Baltimore-Columbia-Towson, MD25$131,35986322
San Antonio-New Braunfels, TX15$118,32686754

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 29 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 99345 nationally

Nurse Practitioner accounts for 51% of payment for 99345 nationally in 2021, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner96667%$4,434,15451%30,78132
Internal Medicine15311%$1,673,43819%9,71163
Family Practice1007.0%$864,73010.0%5,10651
General Practice352.4%$510,6815.9%2,90283
Physician Assistant694.8%$339,2203.9%2,31133
Hospice and Palliative Care221.5%$133,6861.5%77835
Geriatric Medicine181.3%$86,0010.99%52329
Podiatry120.84%$50,1080.58%30325

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 2021.

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