HCPCS 99490

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

Evaluation and management Work RVU per service 0.61 (2021 fee schedule)

11,981
98th percentile among 6,253 codes billed · 2021
$131M
98th percentile among 6,253 codes billed · 2021
4.3M
98th percentile among 6,253 codes billed · 2021
156
91st percentile among 6,253 codes billed · 2021
1,312
90th percentile among 6,253 codes billed · 2021
-8.5%
Medicare payment on the code vs 2020; billers -3.9% · 2021

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
Texas1,204$15,965,101547,1332171,639
California913$15,030,173454,8031942,079
Florida1,066$14,071,593460,0821571,724
New York901$11,791,633338,2021581,485
Illinois531$6,145,574193,6862061,174
Georgia469$5,886,295207,7862131,665
New Jersey452$5,685,085166,4681481,140
North Carolina515$4,027,500141,849111955
Arizona354$4,026,899136,8421371,558
Louisiana382$3,473,685129,1152141,184
Virginia343$3,293,580107,0781531,004
Mississippi323$3,071,521113,2871961,122
Pennsylvania351$3,009,04299,844185771
South Carolina243$2,693,70095,9791841,418
Indiana362$2,688,17395,0651051,012

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

Not listed: 9 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
New York-Newark-Jersey City, NY-NJ1,036$14,817,615419,618156
Los Angeles-Long Beach-Anaheim, CA382$6,561,473193,627204
Chicago-Naperville-Elgin, IL-IN488$5,804,575181,496216
Miami-Fort Lauderdale-West Palm Beach, FL262$2,725,44085,957158
Phoenix-Mesa-Chandler, AZ242$2,716,01691,213137
Dallas-Fort Worth-Arlington, TX249$2,477,44983,586153
Washington-Arlington-Alexandria, DC-VA-MD-WV175$2,349,71370,293152
Atlanta-Sandy Springs-Roswell, GA198$2,311,34180,605208
Houston-Pasadena-The Woodlands, TX239$2,190,66872,394145
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD221$2,064,59863,944161
San Antonio-New Braunfels, TX164$2,042,59768,452214
Amarillo, TX69$1,752,81861,323384
Tampa-St. Petersburg-Clearwater, FL198$1,596,60053,134118
Detroit-Warren-Dearborn, MI164$1,407,08045,410128
Richmond, VA109$1,335,66444,604326

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 2021.

Specialties billing 99490 nationally

Internal Medicine accounts for 38% of payment for 99490 nationally in 2021, across 32 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine3,49029%$49,597,34838%1,617,946464
Family Practice3,60430%$36,342,90628%1,241,270344
Nurse Practitioner1,82215%$8,158,5046.2%308,709169
Cardiology4123.4%$7,422,8815.7%238,664579
Urology4143.5%$4,925,0213.8%164,553397
Nephrology3653.0%$4,608,1733.5%145,123398
Gastroenterology2972.5%$2,306,6851.8%72,683245
General Practice1581.3%$1,941,2311.5%61,923392
Physician Assistant4163.5%$1,840,1581.4%69,531167
Hematology-Oncology880.73%$1,672,7161.3%49,333561
Endocrinology860.72%$1,552,6541.2%48,584565
Interventional Cardiology990.83%$1,291,5890.99%42,593430
Pulmonary Disease1070.89%$1,235,7810.95%38,751362
Geriatric Medicine820.68%$1,024,4660.78%32,156392
Emergency Medicine390.33%$830,6870.64%26,331675

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 2021.

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