HCPCS 99490

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

Evaluation and management Work RVU per service 1.00 (2024 fee schedule)

18,757
99th percentile among 6,471 codes billed · 2024
$303M
99th percentile among 6,471 codes billed · 2024
6.7M
99th percentile among 6,471 codes billed · 2024
149
88th percentile among 6,471 codes billed · 2024
1,181
87th percentile among 6,471 codes billed · 2024
+16.0%
Medicare payment on the code vs 2023; billers +15.7% · 2024

Trend

Medicare payment on the code

$0$200M2020: $143M paid20202021: $131M paid20212022: $212M paid20222023: $262M paid20232024: $303M paid2024$303M$0$200M2020: $143M paid20202021: $131M paid20212022: $212M paid20222023: $262M paid20232024: $303M paid2024$303M$0$200M2020: $143M paid20202021: $131M paid20212022: $212M paid20222023: $262M paid20232024: $303M paid2024$303M$0$200M2020: $143M paid20202021: $131M paid20212022: $212M paid20222023: $262M paid20232024: $303M paid2024$303M

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

Billers

010K20K2020: 12K providers20202021: 12K providers20212022: 14K providers20222023: 16K providers20232024: 19K providers202419K010K20K2020: 12K providers20202021: 12K providers20212022: 14K providers20222023: 16K providers20232024: 19K providers202419K010K20K2020: 12K providers20202021: 12K providers20212022: 14K providers20222023: 16K providers20232024: 19K providers202419K010K20K2020: 12K providers20202021: 12K providers20212022: 14K providers20222023: 16K providers20232024: 19K providers202419K

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
202418,757$303,492,327+16%6,682,7601491,1811.00
202316,216$261,599,721+24%5,676,6901431,1771.00
202213,567$211,680,232+62%4,591,4561461,1851.00
202111,981$130,752,610-8%4,343,9971561,3120.61
202012,468$142,842,027first year in data4,635,0021561,4170.61

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
California1,340$33,083,699668,8701961,985
Texas1,775$27,886,336623,3411711,242
Florida1,349$27,683,176595,7011741,793
New York1,307$27,023,904543,2661441,391
Connecticut173$21,988,976449,2481331,206
Georgia843$11,574,050265,1181251,161
Virginia716$11,333,130247,5681461,502
New Jersey615$9,986,865195,8701541,204
Arizona599$9,983,990227,4451841,509
North Carolina799$8,585,284203,583138817
Illinois720$8,498,709181,642141867
Pennsylvania705$7,777,379178,745126757
South Carolina647$7,159,098163,743127913
Alabama464$6,624,145154,0641681,110
Maryland301$5,972,639125,3552131,172

Not listed: 1 billers with an armed-forces or unknown state code (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 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,507$31,865,455629,889161
Bridgeport-Stamford-Danbury, CT51$20,496,591417,381133
Los Angeles-Long Beach-Anaheim, CA524$13,589,726272,213184
Chicago-Naperville-Elgin, IL-IN621$7,906,742169,227150
Phoenix-Mesa-Chandler, AZ417$7,135,979159,500166
Washington-Arlington-Alexandria, DC-VA-MD-WV472$6,997,920145,104151
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD491$6,488,375140,510145
Houston-Pasadena-The Woodlands, TX450$5,372,170115,257148
Dallas-Fort Worth-Arlington, TX388$5,254,230116,858128
Miami-Fort Lauderdale-West Palm Beach, FL325$5,149,693109,998107
Atlanta-Sandy Springs-Roswell, GA392$4,457,759100,190119
Richmond, VA168$4,424,13297,239323
Detroit-Warren-Dearborn, MI285$3,969,42184,522124
St. Louis, MO-IL84$3,965,00882,657185
San Antonio-New Braunfels, TX188$3,464,07375,841240

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 2024.

Specialties billing 99490 nationally

Internal Medicine accounts for 30% of payment for 99490 nationally in 2024, across 34 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine4,28623%$90,966,70130%1,956,392456
Family Practice4,42724%$63,937,84521%1,447,618327
Nurse Practitioner3,96521%$30,840,49010%774,878195
Cardiology5382.9%$19,873,3126.5%414,965771
Geriatric Medicine860.46%$19,682,8446.5%405,1454,711
Urology1,1336.0%$17,592,4615.8%372,655329
Nephrology9625.1%$10,902,9643.6%239,358249
Physician Assistant8934.8%$8,238,5782.7%205,443230
Gastroenterology5472.9%$6,415,4292.1%134,099245
Interventional Cardiology1500.80%$4,266,6891.4%90,540604
Pulmonary Disease1810.96%$3,722,6641.2%78,466434
Endocrinology1370.73%$3,482,1251.1%73,391536
General Practice1640.87%$2,811,1060.93%59,662364
Hematology-Oncology1370.73%$2,569,3590.85%51,037373
Emergency Medicine960.51%$2,545,9570.84%51,520537

Not listed: 24 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 99490 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