HCPCS 99345

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

Evaluation and management Work RVU per service 3.88 (2023 fee schedule)

3,167
93rd percentile among 6,405 codes billed · 2023
$17M
91st percentile among 6,405 codes billed · 2023
124K
87th percentile among 6,405 codes billed · 2023
24
51st percentile among 6,405 codes billed · 2023
107
56th percentile among 6,405 codes billed · 2023
+94.2%
Medicare payment on the code vs 2022; billers +115.4% · 2023

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
California287$3,586,93623,52328343
Florida376$2,148,05315,76829116
Texas306$1,691,65612,75327117
New York142$934,7335,95323116
Illinois149$739,0555,2092291
New Jersey97$626,6594,18133117
Maryland92$533,7253,88129100
Arizona119$520,9514,10124106
North Carolina130$481,7013,8262460
Pennsylvania103$428,0843,0272257
Massachusetts80$414,6173,03828101
Michigan115$399,4143,0152058
South Carolina80$384,0653,0432590
Virginia79$313,1152,2862659
Georgia77$295,8572,3481974

Not listed: 13 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
Los Angeles-Long Beach-Anaheim, CA140$2,524,74916,61431
New York-Newark-Jersey City, NY-NJ157$1,179,9127,44631
Chicago-Naperville-Elgin, IL-IN139$710,6864,98822
Dallas-Fort Worth-Arlington, TX116$633,7204,80831
Miami-Fort Lauderdale-West Palm Beach, FL82$562,0793,97932
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD101$509,0393,43622
Houston-Pasadena-The Woodlands, TX71$457,5243,33427
Phoenix-Mesa-Chandler, AZ88$407,3183,15824
Washington-Arlington-Alexandria, DC-VA-MD-WV79$391,5872,75728
Boston-Cambridge-Newton, MA-NH73$362,3412,68428
Riverside-San Bernardino-Ontario, CA21$359,7722,29075
Tampa-St. Petersburg-Clearwater, FL75$337,8462,46524
Baltimore-Columbia-Towson, MD57$321,3422,39729
San Diego-Chula Vista-Carlsbad, CA49$308,2682,04433
Atlanta-Sandy Springs-Roswell, GA52$235,0561,84724

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 58 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 99345 nationally

Nurse Practitioner accounts for 54% of payment for 99345 nationally in 2023, across 13 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner2,19169%$9,254,62254%72,52833
Internal Medicine34111%$2,599,30515%16,87049
Family Practice1926.1%$1,798,23711%11,84162
General Practice401.3%$814,4194.8%5,172129
Physician Assistant1665.2%$730,0164.3%5,74635
Emergency Medicine210.66%$264,3441.6%1,72482
Optometry140.44%$186,8731.1%1,16083
Podiatry331.0%$177,5571.0%1,13234
Geriatric Medicine501.6%$177,5111.0%1,18224
Hospice and Palliative Care250.79%$157,8780.93%97739
Psychiatry160.51%$113,8810.67%67742
Hospitalist150.47%$75,3640.44%54636
Certified Clinical Nurse Specialist160.51%$60,4410.36%47830

Not listed: 22 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 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