HCPCS 99490

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

Evaluation and management Work RVU per service 1.00 (2022 fee schedule)

13,567
98th percentile among 6,326 codes billed · 2022
$212M
99th percentile among 6,326 codes billed · 2022
4.6M
99th percentile among 6,326 codes billed · 2022
146
90th percentile among 6,326 codes billed · 2022
1,185
89th percentile among 6,326 codes billed · 2022
+61.9%
Medicare payment on the code vs 2021; billers +13.2% · 2022

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
California955$24,008,559484,2322032,198
Texas1,304$23,849,966536,4401771,399
New York1,127$21,180,192401,0771501,369
Florida1,104$20,024,620428,0851361,624
Georgia541$9,324,748215,2981851,529
Illinois590$9,185,597191,099177995
Connecticut164$8,260,811149,610128911
Arizona405$7,944,991176,7711591,734
New Jersey432$7,294,738142,724144892
North Carolina656$6,295,202146,640107742
Virginia375$5,480,997119,294172988
Pennsylvania430$5,419,629118,355172780
Mississippi336$4,855,070115,4471811,122
Louisiana366$4,814,655114,3311871,045
Indiana441$4,530,657102,381101881

Not listed: 2 billers with an armed-forces or unknown state code (XX, ZZ); they are in the national totals.

Not listed: 6 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-NJ1,262$24,800,317465,629150
Los Angeles-Long Beach-Anaheim, CA396$10,395,072207,066208
Chicago-Naperville-Elgin, IL-IN559$8,902,102184,126184
Bridgeport-Stamford-Danbury, CT57$7,105,435125,109169
Phoenix-Mesa-Chandler, AZ279$5,787,707127,050158
Houston-Pasadena-The Woodlands, TX289$3,836,92881,907148
Dallas-Fort Worth-Arlington, TX249$3,625,93282,051153
Miami-Fort Lauderdale-West Palm Beach, FL241$3,461,03572,481137
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD271$3,319,80467,992168
San Antonio-New Braunfels, TX168$3,236,09171,436234
Atlanta-Sandy Springs-Roswell, GA228$3,144,39071,339155
Washington-Arlington-Alexandria, DC-VA-MD-WV158$2,899,46358,277142
Tampa-St. Petersburg-Clearwater, FL220$2,709,53858,628135
Detroit-Warren-Dearborn, MI225$2,601,47055,217131
Amarillo, TX87$2,478,51757,933243

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 2022.

Specialties billing 99490 nationally

Internal Medicine accounts for 35% of payment for 99490 nationally in 2022, across 32 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine3,64727%$75,082,86635%1,611,216442
Family Practice3,64127%$54,096,00426%1,212,551333
Nurse Practitioner2,54819%$16,736,9787.9%408,408160
Cardiology4193.1%$12,645,3936.0%261,611624
Urology5584.1%$8,177,8843.9%176,458316
Geriatric Medicine710.52%$7,271,2053.4%128,1311,805
Nephrology3542.6%$6,956,8463.3%146,064413
Gastroenterology4333.2%$5,114,2722.4%107,037247
Physician Assistant6244.6%$3,743,7771.8%91,453147
General Practice1581.2%$2,603,0181.2%54,476345
Endocrinology1080.80%$2,549,1551.2%53,720497
Interventional Cardiology1080.80%$2,348,7951.1%49,681460
Hematology-Oncology1040.77%$2,276,6831.1%43,095414
Pulmonary Disease1250.92%$2,123,6581.0%43,715350
Neurology690.51%$1,303,0680.62%24,973362

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 2022.

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