HCPCS 99442

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

Evaluation and management Work RVU per service 1.30 (2022 fee schedule)

32,238
99th percentile among 6,326 codes billed · 2022
$94M
98th percentile among 6,326 codes billed · 2022
1.6M
97th percentile among 6,326 codes billed · 2022
24
50th percentile among 6,326 codes billed · 2022
151
64th percentile among 6,326 codes billed · 2022
-31.2%
Medicare payment on the code vs 2021; billers -32.6% · 2022

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
California4,432$19,440,322310,94429220
New York3,407$17,168,220247,18829264
Massachusetts1,882$5,267,54692,36226152
Florida1,278$4,610,26474,94426186
New Jersey1,159$4,041,08563,39827177
Texas1,620$4,038,59173,96024124
Illinois1,733$3,944,91866,68223105
Pennsylvania1,503$3,115,69758,09922111
Michigan1,084$2,684,52250,44125156
Maryland766$2,365,27241,78525193
Ohio1,299$1,953,77840,7172182
Arizona741$1,905,10335,65025155
Virginia780$1,896,60334,39624122
North Carolina925$1,717,16531,6502188
Washington658$1,528,95426,8212397

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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ2,977$16,645,877232,38131
Los Angeles-Long Beach-Anaheim, CA1,667$7,470,347117,16328
Chicago-Naperville-Elgin, IL-IN1,479$3,449,04957,38123
Boston-Cambridge-Newton, MA-NH1,142$3,344,32857,05425
San Francisco-Oakland-Fremont, CA554$2,276,63134,47927
Detroit-Warren-Dearborn, MI612$1,840,09933,00327
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD634$1,771,69529,63124
Miami-Fort Lauderdale-West Palm Beach, FL371$1,698,58526,43229
Washington-Arlington-Alexandria, DC-VA-MD-WV463$1,579,25525,51926
Providence-Warwick, RI-MA506$1,379,84623,09026
Riverside-San Bernardino-Ontario, CA348$1,377,11023,90829
Dallas-Fort Worth-Arlington, TX386$1,247,54021,89623
Baltimore-Columbia-Towson, MD401$1,131,13220,48223
Phoenix-Mesa-Chandler, AZ441$1,100,53120,15424
San Diego-Chula Vista-Carlsbad, CA370$1,085,82217,24227

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 2022.

Specialties billing 99442 nationally

Internal Medicine accounts for 25% of payment for 99442 nationally in 2022, across 54 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine6,57020%$23,836,33625%380,56658
Family Practice5,02416%$13,463,92114%228,54645
Nurse Practitioner6,11219%$12,218,51513%244,81540
Psychiatry1,0233.2%$6,625,2287.0%107,296105
Physician Assistant2,5307.8%$5,200,2665.5%102,34340
Cardiology1,1543.6%$3,723,7554.0%60,31652
Urology9162.8%$2,404,7252.6%39,34443
Hematology-Oncology9322.9%$2,328,2382.5%40,30343
Gastroenterology6802.1%$1,987,1562.1%31,47746
Pulmonary Disease6972.2%$1,810,6601.9%29,44242
Nephrology6952.2%$1,669,5141.8%31,51545
Physical Medicine and Rehabilitation3190.99%$1,613,1891.7%24,87678
Pain Management2010.62%$1,579,3961.7%25,254126
Anesthesiology2260.70%$1,480,2231.6%23,401104
Neurology5101.6%$1,322,1271.4%21,78243

Not listed: 18 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 2022.

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