HCPCS 99443

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

Evaluation and management Work RVU per service 1.92 (2024 fee schedule)

12,074
98th percentile among 6,471 codes billed · 2024
$55M
96th percentile among 6,471 codes billed · 2024
619K
94th percentile among 6,471 codes billed · 2024
26
52nd percentile among 6,471 codes billed · 2024
163
64th percentile among 6,471 codes billed · 2024
-7.3%
Medicare payment on the code vs 2023; billers -15.5% · 2024

Trend

Medicare payment on the code

$0$100M$200M2020: $207M paid20202021: $138M paid20212022: $88M paid20222023: $59M paid20232024: $55M paid2024$55M$0$100M$200M2020: $207M paid20202021: $138M paid20212022: $88M paid20222023: $59M paid20232024: $55M paid2024$55M$0$100M$200M2020: $207M paid20202021: $138M paid20212022: $88M paid20222023: $59M paid20232024: $55M paid2024$55M$0$100M$200M2020: $207M paid20202021: $138M paid20212022: $88M paid20222023: $59M paid20232024: $55M paid2024$55M

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

Billers

025K50K2020: 59K providers20202021: 33K providers20212022: 22K providers20222023: 14K providers20232024: 12K providers202412K025K50K2020: 59K providers20202021: 33K providers20212022: 22K providers20222023: 14K providers20232024: 12K providers202412K025K50K2020: 59K providers20202021: 33K providers20212022: 22K providers20222023: 14K providers20232024: 12K providers202412K025K50K2020: 59K providers20202021: 33K providers20212022: 22K providers20222023: 14K providers20232024: 12K providers202412K

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
202412,074$54,753,774-7%618,679261631.92
202314,283$59,082,491-33%703,493251541.92
202221,912$88,125,583-36%1,059,539251511.92
202132,989$138,096,626-33%1,667,841271571.92
202059,497$207,207,145first year in data2,763,732271420.75

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
California2,426$16,563,178174,80929248
Massachusetts1,621$6,350,94172,54426146
New York1,034$5,797,63460,07830211
Illinois854$3,280,68036,71524133
Texas677$3,050,60336,77626191
Florida575$3,028,55334,96928197
New Jersey315$1,918,88519,94331177
Maryland312$1,284,49415,27426143
Arizona280$1,164,72314,10827127
Pennsylvania295$982,98311,62324138
Michigan333$894,47311,52022102
Washington235$675,8417,9432292
Virginia186$674,3087,85824126
Connecticut123$595,0606,65225138
Ohio268$573,2847,6662077

Not listed: 2 billers with an armed-forces or unknown state code (AE, XX); they are in the national totals.

Not listed: 6 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
Los Angeles-Long Beach-Anaheim, CA941$7,830,53381,02232
New York-Newark-Jersey City, NY-NJ1,007$6,270,19363,01831
Boston-Cambridge-Newton, MA-NH1,322$5,185,73558,65926
Chicago-Naperville-Elgin, IL-IN801$3,058,22234,31524
Riverside-San Bernardino-Ontario, CA165$1,663,22017,68629
San Francisco-Oakland-Fremont, CA329$1,643,46316,37626
Miami-Fort Lauderdale-West Palm Beach, FL180$1,212,79913,53135
Washington-Arlington-Alexandria, DC-VA-MD-WV234$1,158,17212,52827
Phoenix-Mesa-Chandler, AZ200$857,25310,23327
Sacramento-Roseville-Folsom, CA127$840,0618,95125
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD162$803,8368,72026
San Diego-Chula Vista-Carlsbad, CA162$794,0638,42629
Houston-Pasadena-The Woodlands, TX218$771,7588,81626
Dallas-Fort Worth-Arlington, TX179$749,8138,75723
San Jose-Sunnyvale-Santa Clara, CA142$634,8506,13723

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 92 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 99443 nationally

Internal Medicine accounts for 21% of payment for 99443 nationally in 2024, across 52 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine2,07617%$11,601,09521%127,08961
Nurse Practitioner2,58121%$9,645,41618%124,12248
Family Practice9638.0%$4,388,5418.0%49,50851
Psychiatry4733.9%$3,015,1085.5%34,00572
Cardiology5224.3%$2,809,8685.1%29,36056
Physician Assistant8096.7%$2,194,1004.0%28,92036
Hematology-Oncology4994.1%$2,055,0093.8%21,99044
Anesthesiology980.81%$1,567,3612.9%15,603159
Urology3773.1%$1,508,0032.8%15,85242
Pulmonary Disease2832.3%$1,196,4412.2%12,74445
Neurology3052.5%$1,165,1332.1%12,33940
Physical Medicine and Rehabilitation1291.1%$1,137,0292.1%11,37888
Gastroenterology2812.3%$1,088,2172.0%12,13243
Nephrology2672.2%$988,0631.8%11,86044
Endocrinology2442.0%$902,0641.6%9,78340

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 2024.

Top billers of 99443 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