HCPCS 99443

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

Evaluation and management Work RVU per service 1.92 (2021 fee schedule)

32,989
99th percentile among 6,253 codes billed · 2021
$138M
98th percentile among 6,253 codes billed · 2021
1.7M
97th percentile among 6,253 codes billed · 2021
27
55th percentile among 6,253 codes billed · 2021
157
65th percentile among 6,253 codes billed · 2021
-33.4%
Medicare payment on the code vs 2020; billers -44.6% · 2021

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
California4,458$27,072,557301,34132227
Massachusetts4,423$20,730,607246,71033172
New York2,182$11,818,579125,73227199
Florida1,098$6,716,57575,36529230
Texas1,539$6,222,93178,56626162
Illinois1,697$5,851,61368,69926120
Pennsylvania1,437$4,167,63653,08923113
Maryland834$3,827,46343,23027190
Michigan988$3,748,62649,18725169
New Jersey706$3,594,16438,24628183
Arizona872$3,358,16144,23430154
North Carolina1,027$3,080,71241,97326118
Virginia762$3,061,73738,06225134
Ohio1,153$2,841,19040,5962393
Minnesota1,076$2,636,84932,6612175

Not listed: 3 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 2021.

Top metro areas

observed calculated calculated calculated calculated
Boston-Cambridge-Newton, MA-NH3,466$15,984,777187,77433
New York-Newark-Jersey City, NY-NJ1,813$11,315,191111,60728
Los Angeles-Long Beach-Anaheim, CA1,465$9,621,055105,38933
Chicago-Naperville-Elgin, IL-IN1,527$5,469,72964,03326
San Francisco-Oakland-Fremont, CA746$3,811,31740,18928
Washington-Arlington-Alexandria, DC-VA-MD-WV521$3,053,14432,25426
Riverside-San Bernardino-Ontario, CA350$2,634,98130,45133
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD736$2,314,75027,81624
Providence-Warwick, RI-MA538$2,255,54327,18529
Miami-Fort Lauderdale-West Palm Beach, FL393$2,250,17024,40929
Phoenix-Mesa-Chandler, AZ554$2,228,28128,42227
Baltimore-Columbia-Towson, MD484$2,109,50923,94026
Detroit-Warren-Dearborn, MI418$2,055,33725,00726
Minneapolis-St. Paul-Bloomington, MN-WI832$2,050,91325,12422
San Diego-Chula Vista-Carlsbad, CA447$1,744,63319,19428

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 2021.

Specialties billing 99443 nationally

Internal Medicine accounts for 20% of payment for 99443 nationally in 2021, across 57 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine6,04218%$27,998,35820%329,25454
Nurse Practitioner5,71417%$18,719,15314%261,60846
Family Practice3,68311%$15,048,48811%182,23049
Psychiatry1,7035.2%$11,811,4568.6%138,28881
Cardiology1,5794.8%$7,299,4075.3%85,81254
Nephrology1,1723.6%$5,354,8413.9%62,63753
Physician Assistant1,8185.5%$5,049,7073.7%70,58939
Endocrinology1,1883.6%$4,942,2203.6%59,75650
Hematology-Oncology9773.0%$4,320,3833.1%49,89151
Neurology1,2053.7%$4,263,8923.1%49,90741
Pulmonary Disease1,0223.1%$4,052,6482.9%46,21445
Gastroenterology1,0793.3%$3,888,1532.8%43,51440
Urology5831.8%$2,620,8841.9%28,05448
Rheumatology6452.0%$2,298,5011.7%28,57944
Physical Medicine and Rehabilitation2680.81%$2,185,8101.6%23,53788

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 2021.

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