HCPCS G9678

Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation a (CMS descriptor)

Other services Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

1,564
89th percentile among 6,326 codes billed · 2022
$40M
95th percentile among 6,326 codes billed · 2022
250K
90th percentile among 6,326 codes billed · 2022
108
87th percentile among 6,326 codes billed · 2022
425
79th percentile among 6,326 codes billed · 2022
-76.8%
Medicare payment on the code vs 2021; billers -25.2% · 2022

Trend

Medicare payment on the code

$0$100M2020: $179M paid20202021: $172M paid20212022: $40M paid2022$40M$0$100M2020: $179M paid20202021: $172M paid20212022: $40M paid2022$40M$0$100M2020: $179M paid20202021: $172M paid20212022: $40M paid2022$40M$0$100M2020: $179M paid20202021: $172M paid20212022: $40M paid2022$40M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

Billers

01,0002,0002020: 2,174 providers20202021: 2,091 providers20212022: 1,564 providers20221,56401,0002,0002020: 2,174 providers20202021: 2,091 providers20212022: 1,564 providers20221,56401,0002,0002020: 2,174 providers20202021: 2,091 providers20212022: 1,564 providers20221,56401,0002,0002020: 2,174 providers20202021: 2,091 providers20212022: 1,564 providers20221,564

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

observed calculated calculated calculated calculated calculated reported
20221,564$39,846,168-77%249,7141084250.00
20212,091$172,115,144-4%1,073,5023081,4290.00
20202,174$178,661,850first year in data1,124,0393101,3410.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2022.

By state

observed calculated calculated calculated calculated calculated
Texas394$8,180,59751,27594270
Florida135$6,019,38437,682159954
Virginia129$2,927,71918,351107396
Tennessee103$2,473,54015,498116253
Illinois86$2,225,87313,945132275
Arizona85$1,840,30111,541101388
California45$1,696,99610,653169631
Alabama52$1,310,2538,209122330
Ohio49$1,213,8007,616138455
New York73$1,060,3096,64262218
Michigan31$1,038,3806,516146368
South Carolina16$1,031,8536,4722081,127
New Jersey45$1,021,0706,397126322
Pennsylvania19$987,4726,1911541,115
Colorado40$885,0505,546123251

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

Not listed: 14 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
Dallas-Fort Worth-Arlington, TX180$3,082,97619,32684
Houston-Pasadena-The Woodlands, TX48$1,616,67810,12968
Chicago-Naperville-Elgin, IL-IN60$1,498,4989,390112
New York-Newark-Jersey City, NY-NJ72$1,429,2038,95584
Phoenix-Mesa-Chandler, AZ67$1,248,3567,83095
Nashville-Davidson--Murfreesboro--Franklin, TN40$1,190,3107,457113
Washington-Arlington-Alexandria, DC-VA-MD-WV34$1,129,1607,079124
Tampa-St. Petersburg-Clearwater, FL24$1,021,3256,397208
Austin-Round Rock-San Marcos, TX45$947,5465,940105
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD16$881,2225,526140
Orlando-Kissimmee-Sanford, FL16$815,6875,108225
North Port-Bradenton-Sarasota, FL13$806,6615,052363
San Francisco-Oakland-Fremont, CA12$762,4224,789364
Cincinnati, OH-KY-IN28$705,6014,428152
San Antonio-New Braunfels, TX37$660,7154,14092

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 41 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 G9678 nationally

Hematology-Oncology accounts for 68% of payment for G9678 nationally in 2022, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Hematology-Oncology1,00564%$27,115,32468%169,929169
Medical Oncology37024%$9,367,15424%58,698159
Internal Medicine402.6%$1,193,1563.0%7,476187
Hematology201.3%$616,2061.5%3,867193
Radiation Oncology382.4%$557,1631.4%3,49392
Gynecological Oncology312.0%$269,2000.68%1,68654
Nurse Practitioner161.0%$208,8270.52%1,31082
Urology161.0%$200,6480.50%1,25879

Not listed: 5 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 G9678 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