HCPCS 99443

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

Evaluation and management Work RVU per service 1.92 (2022 fee schedule)

21,912
99th percentile among 6,326 codes billed · 2022
$88M
97th percentile among 6,326 codes billed · 2022
1.1M
95th percentile among 6,326 codes billed · 2022
25
52nd percentile among 6,326 codes billed · 2022
151
64th percentile among 6,326 codes billed · 2022
-36.2%
Medicare payment on the code vs 2021; billers -33.6% · 2022

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
California3,498$20,213,023227,73031220
Massachusetts3,006$12,095,548147,94029153
New York1,678$9,732,246102,26828203
Illinois1,359$4,369,18651,52324106
Florida779$3,919,23845,50227172
Texas1,030$3,636,23846,07024133
New Jersey578$3,186,02534,36128195
Maryland538$2,528,29329,55325166
Arizona563$2,230,05828,87326147
Pennsylvania705$2,100,19726,58622110
Michigan675$2,002,78026,89024113
Washington494$1,456,35218,34223110
Ohio645$1,378,92419,6742180
North Carolina496$1,314,41717,40222101
Virginia398$1,293,21616,33122127

Not listed: 6 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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,505$9,942,659100,09929
Boston-Cambridge-Newton, MA-NH2,393$9,554,752114,91128
Los Angeles-Long Beach-Anaheim, CA1,231$7,674,32585,57532
Chicago-Naperville-Elgin, IL-IN1,252$4,076,68547,95125
San Francisco-Oakland-Fremont, CA518$2,421,39026,93428
Riverside-San Bernardino-Ontario, CA237$1,923,01322,07528
Washington-Arlington-Alexandria, DC-VA-MD-WV334$1,713,27319,24527
Phoenix-Mesa-Chandler, AZ361$1,582,25519,91926
Miami-Fort Lauderdale-West Palm Beach, FL250$1,492,69316,42930
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD370$1,401,47516,41023
Baltimore-Columbia-Towson, MD304$1,368,21215,84123
San Diego-Chula Vista-Carlsbad, CA316$1,160,34312,77826
Providence-Warwick, RI-MA324$1,107,98113,57025
Detroit-Warren-Dearborn, MI310$1,076,50313,71327
Dallas-Fort Worth-Arlington, TX319$1,036,55012,79121

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 96 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 99443 nationally

Internal Medicine accounts for 23% of payment for 99443 nationally in 2022, across 52 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine4,19219%$19,986,31123%227,33154
Nurse Practitioner4,13319%$13,134,40815%180,60844
Family Practice2,21010%$8,901,88310%105,08848
Psychiatry1,1095.1%$7,187,6898.2%85,80377
Cardiology9464.3%$4,128,1924.7%46,49549
Physician Assistant1,2495.7%$3,525,2584.0%48,87139
Hematology-Oncology7903.6%$3,006,2303.4%35,98746
Nephrology6803.1%$2,495,3462.8%32,99849
Pulmonary Disease6222.8%$2,350,8562.7%26,91443
Gastroenterology5972.7%$2,286,5032.6%26,15844
Endocrinology6272.9%$2,238,4872.5%27,17143
Neurology6172.8%$2,109,4432.4%24,60740
Urology4582.1%$1,913,9232.2%20,67145
Physical Medicine and Rehabilitation1930.88%$1,189,7591.4%13,37469
Rheumatology3661.7%$1,156,0921.3%14,28039

Not listed: 21 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 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