HCPCS 99442

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

Evaluation and management Work RVU per service 1.30 (2021 fee schedule)

47,825
100th percentile among 6,253 codes billed · 2021
$137M
98th percentile among 6,253 codes billed · 2021
2.4M
98th percentile among 6,253 codes billed · 2021
25
52nd percentile among 6,253 codes billed · 2021
147
63rd percentile among 6,253 codes billed · 2021
-39.5%
Medicare payment on the code vs 2020; billers -50.4% · 2021

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
California5,498$22,992,217373,24231225
New York4,121$20,214,544293,71428252
Florida1,713$10,251,854159,56327172
Massachusetts3,330$9,474,592167,84727155
Texas2,428$6,130,194113,39825129
Pennsylvania2,608$5,637,046105,34522112
New Jersey1,355$4,910,32175,56928189
Illinois2,225$4,823,91684,99323104
Michigan1,479$3,716,71370,57424157
Ohio2,157$3,682,55977,4082397
Maryland1,103$3,653,54760,43526190
Virginia1,445$3,190,34761,06525121
North Carolina1,795$3,160,08062,6482294
Arizona1,142$2,765,67654,02026142
Indiana924$2,031,37241,81324143

Not listed: 7 billers with an armed-forces or unknown state code (AE, AP, XX, 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ3,267$18,954,624259,13031
Los Angeles-Long Beach-Anaheim, CA1,942$8,779,014139,27831
Boston-Cambridge-Newton, MA-NH2,192$5,643,36099,08625
Lakeland-Winter Haven, FL38$4,826,36371,24128
Chicago-Naperville-Elgin, IL-IN1,775$4,152,83570,78723
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,192$3,141,77353,29924
San Francisco-Oakland-Fremont, CA784$3,059,36446,71430
Providence-Warwick, RI-MA752$2,462,88041,66629
Washington-Arlington-Alexandria, DC-VA-MD-WV732$2,315,00336,36624
Detroit-Warren-Dearborn, MI734$2,301,28341,56028
Miami-Fort Lauderdale-West Palm Beach, FL545$1,923,30529,64928
Riverside-San Bernardino-Ontario, CA480$1,923,13734,57029
Dallas-Fort Worth-Arlington, TX630$1,755,00131,09823
Baltimore-Columbia-Towson, MD570$1,725,80828,22523
Phoenix-Mesa-Chandler, AZ665$1,496,35828,54725

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 2021.

Specialties billing 99442 nationally

Internal Medicine accounts for 21% of payment for 99442 nationally in 2021, across 55 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine8,82018%$29,383,49621%485,80255
Family Practice7,56116%$22,631,99317%392,66952
Nurse Practitioner8,67418%$17,234,84713%360,22042
Psychiatry1,6953.5%$10,978,6108.0%177,548105
Physician Assistant3,3737.1%$6,377,2864.7%133,07039
Cardiology2,1144.4%$5,582,0254.1%98,87947
Nephrology1,3272.8%$3,862,4312.8%66,89550
Gastroenterology1,2942.7%$3,386,0382.5%54,10242
Urology1,1902.5%$3,276,8862.4%53,77945
Hematology-Oncology1,2482.6%$3,252,0762.4%55,34444
Pulmonary Disease1,1942.5%$3,165,7972.3%53,86645
Neurology1,0192.1%$2,496,2351.8%43,82143
Endocrinology1,0292.2%$2,468,9361.8%43,43942
Anesthesiology3280.69%$2,422,8501.8%37,644115
Physical Medicine and Rehabilitation4720.99%$2,181,2961.6%33,97472

Not listed: 19 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 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