HCPCS 99358

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

Evaluation and management Work RVU per service 2.10 (2020 fee schedule)

4,194
94th percentile among 6,116 codes billed · 2020
$25M
94th percentile among 6,116 codes billed · 2020
299K
91st percentile among 6,116 codes billed · 2020
31
62nd percentile among 6,116 codes billed · 2020
243
72nd percentile among 6,116 codes billed · 2020

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
California550$4,488,93547,69837283
South Carolina291$2,426,36532,88883287
Florida266$1,937,61022,84131267
Texas273$1,830,78222,26539297
Maryland129$1,386,38715,74337604
Illinois168$1,226,15314,15026204
New York183$994,10110,71925137
North Carolina177$946,22311,67135284
Washington195$866,05010,40031152
Virginia139$788,1449,41332240
Michigan91$758,7149,56735370
New Jersey99$645,0817,16832285
Indiana100$519,3717,10041193
Oregon171$500,5735,9082594
Massachusetts121$484,2395,62029131

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 2020.

Top metro areas

observed calculated calculated calculated calculated
Los Angeles-Long Beach-Anaheim, CA266$2,588,88127,34544
Columbia, SC161$1,466,62220,026118
New York-Newark-Jersey City, NY-NJ204$1,301,25513,94230
Chicago-Naperville-Elgin, IL-IN151$1,132,14112,90625
Washington-Arlington-Alexandria, DC-VA-MD-WV90$932,65710,19135
Baltimore-Columbia-Towson, MD85$868,99210,04732
Seattle-Tacoma-Bellevue, WA148$695,0908,31133
Miami-Fort Lauderdale-West Palm Beach, FL70$602,6126,79829
Tampa-St. Petersburg-Clearwater, FL74$575,2277,01553
Detroit-Warren-Dearborn, MI51$519,1746,56942
Portland-Vancouver-Hillsboro, OR-WA163$472,7005,55125
Virginia Beach-Chesapeake-Norfolk, VA-NC76$461,0065,71333
San Francisco-Oakland-Fremont, CA86$452,4884,53124
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD85$385,7634,38528
Dallas-Fort Worth-Arlington, TX86$366,9574,33133

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 67 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 99358 nationally

Nurse Practitioner accounts for 36% of payment for 99358 nationally in 2020, across 38 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner1,56237%$9,151,25836%121,82878
Internal Medicine60214%$4,403,75018%48,50581
Family Practice2636.3%$2,606,89510%29,330112
Neurology1884.5%$914,2153.6%9,87153
Physician Assistant1674.0%$845,4973.4%11,08466
Cardiology1092.6%$651,4552.6%7,21166
Hematology-Oncology1253.0%$541,0242.2%5,92647
Infectious Disease882.1%$520,7592.1%5,55663
Geriatric Medicine892.1%$503,3152.0%5,58863
Physical Medicine and Rehabilitation571.4%$490,5352.0%5,27292
Hospitalist1072.6%$466,2941.9%4,94346
Hospice and Palliative Care942.2%$449,4281.8%4,73050
Psychiatry501.2%$436,6421.7%4,73095
General Practice240.57%$310,9751.2%3,383141
Pulmonary Disease801.9%$253,2721.0%2,86636

Not listed: 24 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 2020.

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