HCPCS 99442

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

Evaluation and management Work RVU per service 1.30 (2023 fee schedule)

21,242
99th percentile among 6,405 codes billed · 2023
$64M
97th percentile among 6,405 codes billed · 2023
1.1M
96th percentile among 6,405 codes billed · 2023
24
51st percentile among 6,405 codes billed · 2023
154
63rd percentile among 6,405 codes billed · 2023
-32.4%
Medicare payment on the code vs 2022; billers -34.1% · 2023

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
California3,527$14,323,738231,08228218
New York2,505$13,074,949193,69429280
Florida969$3,357,55455,29124205
Massachusetts1,204$3,139,08654,41224147
New Jersey826$2,893,48945,20127171
Illinois1,210$2,777,40445,89722105
Texas1,118$2,466,46744,65123112
Michigan731$1,921,05635,33425170
Pennsylvania803$1,806,58032,68022141
Maryland500$1,538,49227,11926193
Virginia470$1,143,23219,74923126
Washington466$1,099,20520,0802188
Arizona512$1,098,57920,51423136
Ohio682$985,88319,7372072
Georgia344$837,03115,3252398

Not listed: 4 billers with an armed-forces or unknown state code (AE, 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ2,350$12,875,972184,54131
Los Angeles-Long Beach-Anaheim, CA1,430$6,556,726103,03828
Chicago-Naperville-Elgin, IL-IN1,062$2,459,06040,19522
Boston-Cambridge-Newton, MA-NH752$2,024,68134,60924
San Francisco-Oakland-Fremont, CA418$1,500,10822,95925
Miami-Fort Lauderdale-West Palm Beach, FL307$1,475,78023,37028
Detroit-Warren-Dearborn, MI448$1,448,41425,54028
Washington-Arlington-Alexandria, DC-VA-MD-WV338$1,146,03218,19926
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD361$1,136,21119,70624
Riverside-San Bernardino-Ontario, CA259$1,037,34917,75326
Providence-Warwick, RI-MA310$799,52913,42023
Seattle-Tacoma-Bellevue, WA240$726,01212,96721
Phoenix-Mesa-Chandler, AZ317$703,97912,63222
Houston-Pasadena-The Woodlands, TX369$683,17512,58422
San Diego-Chula Vista-Carlsbad, CA241$667,76510,49124

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 97 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing 99442 nationally

Internal Medicine accounts for 26% of payment for 99442 nationally in 2023, across 52 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine4,26320%$16,314,37626%257,81460
Nurse Practitioner4,13619%$8,175,34813%163,06939
Family Practice2,76213%$7,745,37012%130,07647
Physician Assistant1,7348.2%$4,045,6216.4%79,51846
Psychiatry6383.0%$3,986,1076.3%64,387101
Cardiology7283.4%$2,848,4564.5%43,63060
Urology8023.8%$2,048,5053.2%33,58342
Hematology-Oncology7053.3%$1,584,3602.5%27,69439
Gastroenterology4262.0%$1,281,3432.0%20,13447
Physical Medicine and Rehabilitation2561.2%$1,108,9281.7%16,91866
General Practice1100.52%$997,6231.6%15,834144
Pulmonary Disease4001.9%$988,1561.6%15,74539
Anesthesiology1670.79%$895,7471.4%13,96684
Interventional Pain Management840.40%$892,6371.4%13,095156
Neurology3361.6%$884,2941.4%13,76341

Not listed: 17 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 2023.

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