HCPCS 99490

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

Evaluation and management Work RVU per service 1.00 (2023 fee schedule)

16,216
98th percentile among 6,405 codes billed · 2023
$262M
99th percentile among 6,405 codes billed · 2023
5.7M
99th percentile among 6,405 codes billed · 2023
143
89th percentile among 6,405 codes billed · 2023
1,177
88th percentile among 6,405 codes billed · 2023
+23.6%
Medicare payment on the code vs 2022; billers +19.5% · 2023

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
California1,064$27,457,588553,9892102,207
Connecticut171$26,917,542486,809181880
New York1,211$25,375,253501,7341541,457
Texas1,518$24,650,708553,7671791,286
Florida1,196$23,555,091510,7491481,753
Georgia675$10,159,948234,3541601,359
Illinois658$8,670,090184,257153987
New Jersey486$8,044,655158,8821731,195
Virginia513$7,972,578174,8031261,453
Arizona463$7,840,821178,4941431,472
North Carolina750$7,720,156183,316124742
Pennsylvania512$6,448,541146,946172825
South Carolina647$5,776,063134,27084788
Indiana505$5,260,347126,204118857
Louisiana385$5,195,860122,7941941,003

Not listed: 1 billers with an armed-forces or unknown state code (XX); 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ1,342$28,942,301565,742163
Bridgeport-Stamford-Danbury, CT67$25,552,828458,224176
Los Angeles-Long Beach-Anaheim, CA447$11,388,739227,513195
Chicago-Naperville-Elgin, IL-IN603$8,517,926181,938167
Phoenix-Mesa-Chandler, AZ310$5,704,271127,517146
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD338$4,599,147100,547200
Houston-Pasadena-The Woodlands, TX347$4,512,26296,204151
Miami-Fort Lauderdale-West Palm Beach, FL270$4,158,59689,378137
Dallas-Fort Worth-Arlington, TX305$4,118,44093,495128
Richmond, VA147$3,728,00681,949389
Atlanta-Sandy Springs-Roswell, GA302$3,727,95884,412147
Washington-Arlington-Alexandria, DC-VA-MD-WV269$3,671,28675,081109
Detroit-Warren-Dearborn, MI255$3,584,00575,610126
San Antonio-New Braunfels, TX158$2,889,19965,204226
Tampa-St. Petersburg-Clearwater, FL243$2,870,47163,139120

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing 99490 nationally

Internal Medicine accounts for 30% of payment for 99490 nationally in 2023, across 33 specialties on claims.

observed calculated calculated calculated calculated calculated
Internal Medicine3,99425%$78,084,57830%1,688,287423
Family Practice4,08425%$59,077,74823%1,328,538325
Geriatric Medicine770.47%$25,670,7849.8%461,4125,992
Nurse Practitioner3,30520%$23,329,2328.9%582,518176
Cardiology4552.8%$15,555,3435.9%321,764707
Urology9185.7%$12,227,1504.7%263,722287
Nephrology4772.9%$7,479,2632.9%165,531347
Physician Assistant7734.8%$6,776,8482.6%167,344216
Gastroenterology5513.4%$5,864,1122.2%125,641228
Interventional Cardiology1360.84%$3,136,3001.2%65,920485
Pulmonary Disease1450.89%$3,066,4931.2%63,816440
Endocrinology1320.81%$2,905,7541.1%60,461458
Hematology-Oncology1310.81%$2,576,6120.98%49,213376
General Practice1480.91%$2,564,7610.98%54,630369
Pain Management770.47%$1,739,4500.66%37,110482

Not listed: 25 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 2023.

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