HCPCS 99345

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

Evaluation and management Work RVU per service 4.09 (2022 fee schedule)

1,470
88th percentile among 6,326 codes billed · 2022
$8.8M
87th percentile among 6,326 codes billed · 2022
58K
82nd percentile among 6,326 codes billed · 2022
22
45th percentile among 6,326 codes billed · 2022
111
57th percentile among 6,326 codes billed · 2022
+1.1%
Medicare payment on the code vs 2021; billers +2.4% · 2022

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
California168$2,407,69614,46027329
Texas184$1,058,2817,34126124
Florida142$801,3745,37524106
New York95$725,2184,23825109
Illinois73$453,5372,88122113
Michigan57$335,8672,24822106
New Jersey58$325,1412,1082897
Nevada35$249,6921,76029141
Maryland46$239,3791,6402974
North Carolina64$207,8501,4911949
Arizona39$157,2281,1562084
Pennsylvania41$149,6961,0201945
Ohio39$134,3599691861
Virginia28$133,9718842282
Georgia27$129,93097722109

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 2022.

Top metro areas

observed calculated calculated calculated calculated
Los Angeles-Long Beach-Anaheim, CA89$1,848,87811,08038
New York-Newark-Jersey City, NY-NJ98$852,2894,94331
Dallas-Fort Worth-Arlington, TX85$468,0543,28023
Chicago-Naperville-Elgin, IL-IN73$443,8342,83023
Miami-Fort Lauderdale-West Palm Beach, FL39$309,4012,07034
Detroit-Warren-Dearborn, MI40$262,1751,72625
Houston-Pasadena-The Woodlands, TX36$261,0881,70330
Las Vegas-Henderson-North Las Vegas, NV31$235,3201,66335
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD50$199,1611,33723
San Diego-Chula Vista-Carlsbad, CA31$185,5511,10627
Washington-Arlington-Alexandria, DC-VA-MD-WV33$161,5571,06925
Riverside-San Bernardino-Ontario, CA11$140,67782927
Baltimore-Columbia-Towson, MD27$135,55193626
Phoenix-Mesa-Chandler, AZ30$131,44598021
Tampa-St. Petersburg-Clearwater, FL21$117,04873828

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 2022.

Specialties billing 99345 nationally

Nurse Practitioner accounts for 50% of payment for 99345 nationally in 2022, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner99468%$4,374,89750%31,29531
Internal Medicine15811%$1,521,37117%8,98557
Family Practice1026.9%$1,200,93114%7,21571
General Practice332.2%$465,4015.3%2,75183
Physician Assistant785.3%$350,4734.0%2,47332
Emergency Medicine120.82%$136,7341.6%79366
Hospice and Palliative Care181.2%$112,4281.3%67037
Podiatry120.82%$61,0810.70%37731
Geriatric Medicine130.88%$51,1800.58%34426

Not listed: 21 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 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