HCPCS 99358

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

Evaluation and management Work RVU per service 2.10 (2022 fee schedule)

3,730
93rd percentile among 6,326 codes billed · 2022
$26M
94th percentile among 6,326 codes billed · 2022
331K
92nd percentile among 6,326 codes billed · 2022
39
68th percentile among 6,326 codes billed · 2022
293
74th percentile among 6,326 codes billed · 2022
+11.1%
Medicare payment on the code vs 2021; billers +7.1% · 2022

Trend

Medicare payment on the code

$0$10M$20M2020: $25M paid20202021: $24M paid20212022: $26M paid2022$26M$0$10M$20M2020: $25M paid20202021: $24M paid20212022: $26M paid2022$26M$0$10M$20M2020: $25M paid20202021: $24M paid20212022: $26M paid2022$26M$0$10M$20M2020: $25M paid20202021: $24M paid20212022: $26M paid2022$26M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

Billers

02,0004,0002020: 4,194 providers20202021: 3,482 providers20212022: 3,730 providers20223,73002,0004,0002020: 4,194 providers20202021: 3,482 providers20212022: 3,730 providers20223,73002,0004,0002020: 4,194 providers20202021: 3,482 providers20212022: 3,730 providers20223,73002,0004,0002020: 4,194 providers20202021: 3,482 providers20212022: 3,730 providers20223,730

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

observed calculated calculated calculated calculated calculated reported
20223,730$26,169,160+11%331,118392932.10
20213,482$23,556,048-6%288,745362812.10
20204,194$25,091,471first year in data298,906312432.10

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

By state

observed calculated calculated calculated calculated calculated
California501$4,990,76155,82238485
South Carolina391$3,077,26443,38370332
Florida271$2,079,77926,43747322
Texas258$2,061,35426,88842376
Illinois179$1,536,33418,84236361
Nevada53$1,247,55116,4351341,386
Maryland91$793,5609,48234506
Indiana96$716,3789,75844302
North Carolina132$667,4418,85635190
Washington132$600,9457,48431159
Virginia130$571,7187,04832156
Georgia77$565,0547,16256258
Arizona50$550,2086,88959546
Massachusetts93$543,9566,53045226
New York106$499,2835,64331187

Not listed: 10 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, CA257$2,714,38929,60055
Columbia, SC254$2,159,78230,60380
Chicago-Naperville-Elgin, IL-IN157$1,456,59017,74634
Las Vegas-Henderson-North Las Vegas, NV33$825,93710,740228
Tampa-St. Petersburg-Clearwater, FL69$700,4369,02256
Texarkana, TX-AR17$666,4608,31188
Washington-Arlington-Alexandria, DC-VA-MD-WV71$650,3587,46627
New York-Newark-Jersey City, NY-NJ109$546,2005,98231
San Francisco-Oakland-Fremont, CA75$540,7225,90030
Phoenix-Mesa-Chandler, AZ37$493,7696,18468
Atlanta-Sandy Springs-Roswell, GA58$465,8605,84657
Seattle-Tacoma-Bellevue, WA97$454,6785,58532
Greenville-Anderson-Greer, SC52$452,9786,33167
San Diego-Chula Vista-Carlsbad, CA20$451,1895,60931
Riverside-San Bernardino-Ontario, CA24$437,5964,85331

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 70 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 99358 nationally

Nurse Practitioner accounts for 45% of payment for 99358 nationally in 2022, across 26 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner1,94252%$11,857,75645%165,34485
Internal Medicine50213%$4,475,69217%51,237102
Family Practice2115.7%$2,547,6859.7%29,762141
Hospitalist1323.5%$791,6603.0%8,73866
Physician Assistant1624.3%$781,0633.0%10,75366
Physical Medicine and Rehabilitation481.3%$734,5532.8%8,313173
Psychiatry391.0%$606,7982.3%6,960178
Infectious Disease641.7%$474,6031.8%5,27582
Emergency Medicine230.62%$432,0401.7%5,059220
Neurology691.8%$383,2751.5%4,36663
Cardiology360.97%$363,5091.4%4,127115
Geriatric Medicine691.8%$330,5081.3%3,73654
Hospice and Palliative Care671.8%$304,7661.2%3,30949
General Practice210.56%$297,8771.1%3,460165
Hematology-Oncology431.2%$273,0241.0%3,04971

Not listed: 36 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 99358 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