HCPCS 99358

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

Evaluation and management Work RVU per service 2.10 (2021 fee schedule)

3,482
93rd percentile among 6,253 codes billed · 2021
$24M
93rd percentile among 6,253 codes billed · 2021
289K
91st percentile among 6,253 codes billed · 2021
36
66th percentile among 6,253 codes billed · 2021
281
74th percentile among 6,253 codes billed · 2021
-6.1%
Medicare payment on the code vs 2020; billers -17.0% · 2021

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
California419$3,911,77842,29237394
South Carolina356$3,137,88743,07781353
Texas247$1,935,88623,97045357
Florida252$1,786,79121,38343279
Illinois143$1,456,86116,71235315
Maryland94$899,15610,15930490
North Carolina146$766,2489,99430186
Virginia134$710,6738,62529217
Nevada54$686,1218,84166638
New York125$685,9327,42232208
Indiana89$611,0608,39639341
Ohio107$579,3937,65333288
Washington130$519,8056,46728169
Massachusetts101$507,6625,95832164
Michigan70$454,5685,96036267

Not listed: 11 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
Columbia, SC240$2,460,73533,869105
Los Angeles-Long Beach-Anaheim, CA235$2,356,41625,07050
Chicago-Naperville-Elgin, IL-IN131$1,378,78815,64833
New York-Newark-Jersey City, NY-NJ139$759,8708,05032
Washington-Arlington-Alexandria, DC-VA-MD-WV59$680,8177,52635
Baltimore-Columbia-Towson, MD64$671,6227,62438
Texarkana, TX-AR14$560,5306,69578
Tampa-St. Petersburg-Clearwater, FL67$482,8596,06552
Dallas-Fort Worth-Arlington, TX84$474,2415,74341
Las Vegas-Henderson-North Las Vegas, NV29$460,1865,93870
Seattle-Tacoma-Bellevue, WA101$420,1295,17427
Virginia Beach-Chesapeake-Norfolk, VA-NC81$410,3235,06827
Boston-Cambridge-Newton, MA-NH83$386,0414,44431
Miami-Fort Lauderdale-West Palm Beach, FL64$374,2004,28035
Riverside-San Bernardino-Ontario, CA15$359,4373,92650

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 63 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 99358 nationally

Nurse Practitioner accounts for 43% of payment for 99358 nationally in 2021, across 26 specialties on claims.

observed calculated calculated calculated calculated calculated
Nurse Practitioner1,66348%$10,141,33643%138,08483
Internal Medicine47314%$4,194,00118%46,48198
Family Practice2055.9%$2,492,08711%28,175137
Physician Assistant1664.8%$719,3563.1%9,70258
Hospitalist1353.9%$686,8152.9%7,49856
Emergency Medicine220.63%$611,2982.6%6,655303
Physical Medicine and Rehabilitation471.3%$457,7051.9%4,983106
Infectious Disease692.0%$445,7771.9%4,87071
Neurology682.0%$421,1961.8%4,71169
Cardiology371.1%$404,6381.7%4,455120
Hospice and Palliative Care772.2%$358,9801.5%3,80649
Geriatric Medicine702.0%$320,6241.4%3,48150
Hematology-Oncology511.5%$275,6661.2%3,04360
Psychiatry320.92%$274,6411.2%3,04495
General Practice200.57%$256,9901.1%2,851143

Not listed: 34 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 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