HCPCS 99442

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

Evaluation and management Work RVU per service 0.50 (2020 fee schedule)

96,404
100th percentile among 6,116 codes billed · 2020
$226M
99th percentile among 6,116 codes billed · 2020
4.5M
98th percentile among 6,116 codes billed · 2020
28
58th percentile among 6,116 codes billed · 2020
139
63rd percentile among 6,116 codes billed · 2020

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
California7,885$25,330,988458,22132181
Massachusetts6,533$21,351,452405,35737188
New York7,251$20,877,310369,68328159
Pennsylvania6,181$12,806,324256,22727117
Illinois4,718$10,365,796202,91829118
Texas4,709$10,133,723211,74226140
Ohio4,924$8,953,677200,70826116
Florida3,310$8,251,990154,78227142
North Carolina3,927$7,707,785163,09027117
Maryland2,471$7,631,385140,68934168
New Jersey2,671$6,772,950118,71628125
Virginia2,657$6,378,046132,16230152
Michigan3,058$6,249,159136,30726141
Indiana2,722$5,528,500123,89228123
Minnesota2,982$5,175,976105,4492689

Not listed: 15 billers with an armed-forces or unknown state code (AE, AP, ZZ); they are in the national totals.

Not listed: 1 state 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
New York-Newark-Jersey City, NY-NJ5,697$18,823,117308,67529
Boston-Cambridge-Newton, MA-NH4,936$14,752,408280,92235
Chicago-Naperville-Elgin, IL-IN3,744$8,563,565164,32829
Los Angeles-Long Beach-Anaheim, CA2,397$7,807,389137,59529
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD3,068$7,525,418142,91030
Providence-Warwick, RI-MA1,169$4,930,34390,98146
Minneapolis-St. Paul-Bloomington, MN-WI2,190$4,124,76081,47528
San Francisco-Oakland-Fremont, CA1,191$4,077,01070,64033
Baltimore-Columbia-Towson, MD1,431$4,016,74574,26631
Washington-Arlington-Alexandria, DC-VA-MD-WV1,462$3,795,25666,95929
Detroit-Warren-Dearborn, MI1,476$3,467,01971,47427
Charlotte-Concord-Gastonia, NC-SC1,190$2,647,35554,29231
Dallas-Fort Worth-Arlington, TX1,185$2,360,04651,52226
Miami-Fort Lauderdale-West Palm Beach, FL871$2,317,47441,95028
Phoenix-Mesa-Chandler, AZ1,034$2,169,85345,06827

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 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 99442 nationally

Internal Medicine accounts for 23% of payment for 99442 nationally in 2020, across 62 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine18,03619%$50,868,01623%978,44654
Family Practice17,36118%$35,924,95316%735,80042
Nurse Practitioner15,28616%$26,806,08312%631,93841
Cardiology5,8896.1%$16,090,1587.1%309,36453
Psychiatry2,3292.4%$10,517,9904.7%200,83686
Physician Assistant5,9316.2%$9,880,3514.4%228,20738
Nephrology2,5762.7%$6,716,1283.0%125,22549
Pulmonary Disease2,4122.5%$6,355,2412.8%117,71849
Endocrinology2,2662.4%$6,051,7212.7%115,14951
Gastroenterology2,8032.9%$5,681,5802.5%102,84437
Neurology2,6922.8%$5,496,8362.4%106,06239
Hematology-Oncology2,2682.4%$5,316,1442.4%104,59246
Rheumatology1,8241.9%$5,229,1572.3%100,40255
Urology2,0562.1%$4,980,1702.2%92,92145
Physical Medicine and Rehabilitation8810.91%$2,761,0711.2%49,23556

Not listed: 9 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 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