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 (2020 fee schedule; adds 0 work RVUs)

2,174
91st percentile among 6,116 codes billed · 2020
$179M
99th percentile among 6,116 codes billed · 2020
1.1M
96th percentile among 6,116 codes billed · 2020
310
94th percentile among 6,116 codes billed · 2020
1,341
91st percentile among 6,116 codes billed · 2020

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
Florida172$31,724,305199,6934814,339
Texas491$22,950,347144,482226700
Illinois154$12,354,79377,5492671,050
Virginia148$12,149,21076,4924391,197
Tennessee123$11,752,24673,9533821,408
Arizona111$9,697,86260,9622981,326
Ohio103$8,978,04156,6161741,712
New Jersey93$8,510,66453,5924051,642
Connecticut26$5,902,59137,087416788
New York123$5,411,89833,992220715
Alabama61$5,109,47532,159381921
California80$4,285,04126,9161811,171
Oklahoma42$4,034,68825,3973011,946
Colorado41$3,689,84123,220530971
Michigan36$3,689,06423,1704841,171

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

Not listed: 13 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-NJ142$10,196,74864,155267
Dallas-Fort Worth-Arlington, TX243$9,930,93562,536201
Chicago-Naperville-Elgin, IL-IN126$8,719,38354,727194
Phoenix-Mesa-Chandler, AZ88$7,140,61144,881297
Tampa-St. Petersburg-Clearwater, FL25$5,510,17434,6821,247
Nashville-Davidson--Murfreesboro--Franklin, TN48$5,236,54732,951414
Memphis, TN-MS-AR36$4,232,29126,636391
Orlando-Kissimmee-Sanford, FL22$3,963,87624,9381,008
Virginia Beach-Chesapeake-Norfolk, VA-NC44$3,515,97822,149450
Cincinnati, OH-KY-IN38$2,790,64417,593238
Washington-Arlington-Alexandria, DC-VA-MD-WV36$2,723,40217,134449
Austin-Round Rock-San Marcos, TX49$2,714,18617,083259
Tulsa, OK24$2,680,26216,872449
Cleveland, OH13$2,651,45016,74155
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD23$2,457,94915,455356

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 48 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 G9678 nationally

Hematology-Oncology accounts for 66% of payment for G9678 nationally in 2020, across 11 specialties on claims.

observed calculated calculated calculated calculated calculated
Hematology-Oncology1,30060%$118,601,85366%746,240574
Medical Oncology48622%$44,233,98825%278,251573
Internal Medicine632.9%$5,059,7442.8%31,828505
Radiation Oncology673.1%$3,543,8392.0%22,263332
Hematology432.0%$2,268,0901.3%14,279332
Gynecological Oncology713.3%$1,801,1841.0%11,330160
Urology421.9%$1,011,9370.57%6,370152
Nurse Practitioner411.9%$606,9520.34%3,81693
Hematopoietic Cell Transplantation and Cellular Therapy150.69%$499,3870.28%3,146210
Physician Assistant130.60%$311,7530.17%1,961151
Obstetrics & Gynecology110.51%$259,7050.15%1,635149

Not listed: 6 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 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