HCPCS 99349

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

Evaluation and management Work RVU per service 2.33 (2021 fee schedule)

6,485
95th percentile among 6,253 codes billed · 2021
$97M
97th percentile among 6,253 codes billed · 2021
1.1M
95th percentile among 6,253 codes billed · 2021
69
82nd percentile among 6,253 codes billed · 2021
639
83rd percentile among 6,253 codes billed · 2021
+3.8%
Medicare payment on the code vs 2020; billers +7.1% · 2021

Trend

Medicare payment on the code

$0$200M2020: $93M paid20202021: $97M paid20212022: $92M paid20222023: $284M paid20232024: $294M paid2024$294M$0$200M2020: $93M paid20202021: $97M paid20212022: $92M paid20222023: $284M paid20232024: $294M paid2024$294M$0$200M2020: $93M paid20202021: $97M paid20212022: $92M paid20222023: $284M paid20232024: $294M paid2024$294M$0$200M2020: $93M paid20202021: $97M paid20212022: $92M paid20222023: $284M paid20232024: $294M paid2024$294M

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

Billers

010K2020: 6,054 providers20202021: 6,485 providers20212022: 6,773 providers20222023: 14K providers20232024: 15K providers202415K010K2020: 6,054 providers20202021: 6,485 providers20212022: 6,773 providers20222023: 14K providers20232024: 15K providers202415K010K2020: 6,054 providers20202021: 6,485 providers20212022: 6,773 providers20222023: 14K providers20232024: 15K providers202415K010K2020: 6,054 providers20202021: 6,485 providers20212022: 6,773 providers20222023: 14K providers20232024: 15K providers202415K

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
202414,815$294,272,869+4%3,553,7331009252.44
202314,284$284,172,388+208%3,339,308939062.44
20226,773$92,345,900-5%1,070,155676042.33
20216,485$96,793,231+4%1,078,669696392.33
20206,054$93,213,619first year in data1,029,604676972.33

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
Illinois458$12,439,053130,5821011,147
Florida715$12,428,436138,24392664
Texas591$11,126,923130,59988877
New York516$10,805,434105,00578815
California448$7,567,97477,35367680
Michigan343$7,083,14078,679103808
New Jersey301$5,030,61754,66579669
South Carolina292$3,050,21537,49599313
Ohio282$3,034,89436,97762509
Nevada145$2,279,06326,38152908
Kentucky113$2,276,06229,463172708
Pennsylvania218$2,194,79324,61061420
Virginia151$1,816,19020,60162599
Tennessee136$1,446,44518,37969306
Indiana135$1,426,20117,65571423

Not listed: 1 billers with an armed-forces or unknown state code (AE); they are in the national totals.

Not listed: 9 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
New York-Newark-Jersey City, NY-NJ653$13,848,801137,67983
Chicago-Naperville-Elgin, IL-IN440$12,394,293129,946109
Miami-Fort Lauderdale-West Palm Beach, FL235$5,147,68254,682112
Detroit-Warren-Dearborn, MI188$4,669,64550,518125
Dallas-Fort Worth-Arlington, TX229$4,609,48253,816115
Los Angeles-Long Beach-Anaheim, CA239$4,569,77145,88776
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD210$2,824,37931,78383
Columbia, SC205$2,357,56028,913114
Houston-Pasadena-The Woodlands, TX122$2,284,45025,79971
Las Vegas-Henderson-North Las Vegas, NV129$2,208,55725,54556
Louisville/Jefferson County, KY-IN72$1,879,95324,301306
Tampa-St. Petersburg-Clearwater, FL97$1,603,05217,54676
Washington-Arlington-Alexandria, DC-VA-MD-WV103$1,535,23116,89790
Orlando-Kissimmee-Sanford, FL67$1,306,75415,22277
San Diego-Chula Vista-Carlsbad, CA67$1,172,33312,96161

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 73 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 99349 nationally

Nurse Practitioner accounts for 51% of payment for 99349 nationally in 2021, across 15 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner3,92661%$49,515,32851%593,955151
Internal Medicine75112%$15,716,74516%155,881208
Family Practice6199.5%$10,923,57011%112,601182
Physician Assistant4607.1%$7,104,6587.3%82,332179
Podiatry2153.3%$3,637,9553.8%35,888167
General Practice1151.8%$3,456,6563.6%34,498300
Geriatric Medicine1502.3%$1,437,5471.5%14,65698
Emergency Medicine240.37%$563,4010.58%5,742239
Hospitalist180.28%$330,8290.34%3,333185
General Surgery130.20%$321,3130.33%3,041234
Optometry120.19%$281,3360.29%2,652221
Hospice and Palliative Care410.63%$250,2520.26%2,48761
Cardiology160.25%$213,0520.22%2,098131
Certified Clinical Nurse Specialist190.29%$205,2450.21%2,523133
Psychiatry200.31%$181,1070.19%1,80090

Not listed: 32 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 99349 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