HCPCS 99442

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

Evaluation and management Work RVU per service 1.30 (2024 fee schedule)

17,592
98th percentile among 6,471 codes billed · 2024
$58M
96th percentile among 6,471 codes billed · 2024
954K
95th percentile among 6,471 codes billed · 2024
25
51st percentile among 6,471 codes billed · 2024
164
64th percentile among 6,471 codes billed · 2024
-9.0%
Medicare payment on the code vs 2023; billers -17.2% · 2024

Trend

Medicare payment on the code

$0$100M$200M2020: $226M paid20202021: $137M paid20212022: $94M paid20222023: $64M paid20232024: $58M paid2024$58M$0$100M$200M2020: $226M paid20202021: $137M paid20212022: $94M paid20222023: $64M paid20232024: $58M paid2024$58M$0$100M$200M2020: $226M paid20202021: $137M paid20212022: $94M paid20222023: $64M paid20232024: $58M paid2024$58M$0$100M$200M2020: $226M paid20202021: $137M paid20212022: $94M paid20222023: $64M paid20232024: $58M paid2024$58M

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

Billers

050K100K2020: 96K providers20202021: 48K providers20212022: 32K providers20222023: 21K providers20232024: 18K providers202418K050K100K2020: 96K providers20202021: 48K providers20212022: 32K providers20222023: 21K providers20232024: 18K providers202418K050K100K2020: 96K providers20202021: 48K providers20212022: 32K providers20222023: 21K providers20232024: 18K providers202418K050K100K2020: 96K providers20202021: 48K providers20212022: 32K providers20222023: 21K providers20232024: 18K providers202418K

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
202417,592$57,900,800-9%954,193251641.30
202321,242$63,656,557-32%1,072,939241541.30
202232,238$94,144,996-31%1,600,419241511.30
202147,825$136,762,533-39%2,393,622251471.30
202096,404$226,023,691first year in data4,522,663281390.50

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
California3,142$13,853,989214,23527240
New York2,109$12,179,779192,42629294
Florida919$3,567,43457,67826227
New Jersey683$2,666,38841,20827162
Texas983$2,611,73744,87725131
Massachusetts925$2,493,66641,38824169
Illinois983$2,484,80340,57523114
Michigan572$1,648,56729,06425145
Pennsylvania577$1,620,03227,65721131
Maryland448$1,478,31625,41027209
Arizona421$1,106,54519,20423171
Virginia379$974,10816,57124136
Ohio473$770,83914,9222187
Georgia282$701,16312,56821103
Washington366$649,53711,0522067

Not listed: 3 billers with an armed-forces or unknown state code (AE, ZZ); they are in the national totals.

Not listed: 3 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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ2,098$11,889,485177,11130
Los Angeles-Long Beach-Anaheim, CA1,350$7,300,622110,60428
Chicago-Naperville-Elgin, IL-IN860$2,255,60336,23023
Miami-Fort Lauderdale-West Palm Beach, FL309$1,475,18823,12029
Boston-Cambridge-Newton, MA-NH562$1,474,16924,23423
San Francisco-Oakland-Fremont, CA333$1,353,34219,19226
Detroit-Warren-Dearborn, MI356$1,284,95521,95430
Washington-Arlington-Alexandria, DC-VA-MD-WV307$1,187,49719,84425
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD258$1,017,34716,15723
Riverside-San Bernardino-Ontario, CA222$870,90314,55127
Houston-Pasadena-The Woodlands, TX332$838,52013,62924
Phoenix-Mesa-Chandler, AZ271$730,76112,32322
Baltimore-Columbia-Towson, MD230$681,59911,56327
Providence-Warwick, RI-MA242$680,58911,14426
San Diego-Chula Vista-Carlsbad, CA213$647,3029,63924

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 98 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.

Specialties billing 99442 nationally

Internal Medicine accounts for 24% of payment for 99442 nationally in 2024, across 54 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine3,31319%$14,099,53324%218,21466
Nurse Practitioner3,62621%$8,776,32715%170,84247
Family Practice2,06912%$6,808,74812%110,71054
Physician Assistant1,4618.3%$3,926,4396.8%77,77353
Psychiatry4212.4%$2,799,2684.8%43,773104
Cardiology6653.8%$2,797,0234.8%42,37064
Urology7674.4%$2,090,1473.6%33,11443
Hematology-Oncology5853.3%$1,356,6442.3%22,09338
Gastroenterology3191.8%$1,014,0621.8%15,03247
Anesthesiology1390.79%$1,004,5981.7%15,119109
Physical Medicine and Rehabilitation2281.3%$987,9461.7%14,93365
General Practice1140.65%$822,3551.4%12,249107
Pulmonary Disease3041.7%$752,3321.3%11,73439
Pain Management1200.68%$705,6091.2%10,39487
Interventional Pain Management770.44%$685,4361.2%10,285134

Not listed: 12 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 2024.

Top billers of 99442 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