HCPCS 99490

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

Evaluation and management Work RVU per service 0.61 (2020 fee schedule)

12,468
98th percentile among 6,116 codes billed · 2020
$143M
98th percentile among 6,116 codes billed · 2020
4.6M
98th percentile among 6,116 codes billed · 2020
156
91st percentile among 6,116 codes billed · 2020
1,417
91st percentile among 6,116 codes billed · 2020

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
Texas1,262$17,699,299587,1552151,762
Florida1,216$16,840,786528,1161601,734
California992$16,634,905498,4891822,178
New York1,012$11,980,378334,5491331,445
Georgia543$7,039,932241,4792321,616
New Jersey415$5,880,060170,3531881,219
Illinois513$5,512,113171,3321701,175
North Carolina540$4,644,971160,7921061,092
Arizona334$4,173,326139,0441431,827
Virginia335$3,732,713118,2652021,093
Louisiana333$3,522,605124,5371931,640
South Carolina221$3,224,275110,7602061,766
Mississippi319$3,204,964117,0172061,253
Alabama243$3,012,232103,5861831,474
Pennsylvania365$2,919,82694,916161788

Not listed: 1 billers with an armed-forces or unknown state code (ZZ); they are in the national totals.

Not listed: 7 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,156$15,243,861422,398143
Los Angeles-Long Beach-Anaheim, CA389$6,720,441195,844179
Chicago-Naperville-Elgin, IL-IN478$5,088,546157,385171
Miami-Fort Lauderdale-West Palm Beach, FL323$3,818,763115,688159
Atlanta-Sandy Springs-Roswell, GA227$2,794,47496,015234
Dallas-Fort Worth-Arlington, TX262$2,687,26288,205136
Washington-Arlington-Alexandria, DC-VA-MD-WV187$2,642,74577,772171
Phoenix-Mesa-Chandler, AZ214$2,611,58986,521108
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD213$2,431,39273,032225
Houston-Pasadena-The Woodlands, TX239$2,372,13476,859176
San Antonio-New Braunfels, TX181$2,142,23069,942182
Amarillo, TX77$2,048,90370,729302
Tampa-St. Petersburg-Clearwater, FL192$1,773,52657,826125
Austin-Round Rock-San Marcos, TX98$1,691,19054,596212
Detroit-Warren-Dearborn, MI177$1,675,44653,099129

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 94 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 99490 nationally

Internal Medicine accounts for 40% of payment for 99490 nationally in 2020, across 31 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine3,81531%$57,061,25740%1,821,292477
Family Practice3,94632%$41,576,92229%1,377,427349
Cardiology4153.3%$8,294,2325.8%263,073634
Nurse Practitioner1,80414%$7,966,0215.6%297,203165
Urology3572.9%$5,219,2853.7%167,724470
Nephrology3823.1%$3,599,4542.5%110,506289
General Practice1731.4%$2,365,3991.7%73,188423
Physician Assistant4063.3%$1,993,4091.4%74,373183
Hematology-Oncology740.59%$1,627,1191.1%45,350613
Endocrinology950.76%$1,485,5651.0%46,042485
Pulmonary Disease1150.92%$1,392,9990.98%43,446378
Interventional Cardiology940.75%$1,358,3230.95%45,215481
Geriatric Medicine940.75%$1,151,1220.81%35,334376
Gastroenterology1291.0%$952,5750.67%29,797231
Emergency Medicine470.38%$936,4220.66%30,288644

Not listed: 22 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 2020.

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