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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
96112 Administration of developmental test, first hour CPT · E&M
Classification E&M Behavioral Health Services (CMS RBCS)
First observed 2019
National scale 11,548 services ▼ 7.3% YoY · 2,260 beneficiaries (CY2024, Medicare FFS)
Medicare paid $1.0M · $88.06 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
21
Named-group FFS services
6,398
FFS of Medicare
49%
Services YoY
-7.3%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~12,826 services

6,398 observed fee-for-service (50%) · ~6,428 estimated Medicare Advantage. Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale

Top states — 96112 (CY2024)

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Named-group submitted charges
$1.4M
Named-group allowed amount
$730K
Named-group Medicare payments
$575K
Avg charge / svc
$216
Avg allowed / svc
$114
Avg payment / svc
$90
Average charge per group
$150 21 groups · avg submitted charge / service $589
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 96112 services, highest first, CY2024
# Physician group activate to sort City activate to sort St activate to sort Specialty activate to sort Providers activate to sort 96112 svcs sorted descending — activate to reverse Submitted charges activate to sort Avg charge activate to sort Medicare $ locked column Share* activate to sort Phone
1 DEL SUR HEALTHCARE EL CAJON CA NURSE PRACTITIONER 62 1,315 $257,641 $196 premium 27.3% (760) 978-8596
2 RANCHO SANTA FE MEDICAL GROUP, INC. OCEANSIDE CA FAMILY PRACTICE 2 853 $162,070 $190 premium 17.7% (760) 591-9975
3 TRI-COUNTY COMMUNITY CLINIC LLC PORTAGEVILLE MO NURSE PRACTITIONER 4 743 $148,600 $200 premium 37.0% (573) 391-8031
4 DFW PHYSICIANS MEDICAL ASSOCIATES LLC SHERMAN TX PSYCHIATRY 7 681 $234,350 $344 premium 80.8% (903) 957-0082
5 ADVANCED TMS CLINIC INC NATIONAL CITY CA PSYCHIATRY 2 627 $132,150 $211 premium 13.0% (619) 267-9257
6 MCPHERSON MEDICAL AND DIAGNOSTIC LLC KENNETT MO NURSE PRACTITIONER 76 450 $96,716 $215 premium 22.4% (573) 717-1072
7 BEHAVIORAL HEALTH INSTITUTE INC (SINGH) PC LAS VEGAS NV NURSE PRACTITIONER 13 347 $65,930 $190 premium 56.1% (702) 852-6633
8 PHOENIX REHABILITATION AND HEALTH SERVICES INC CRANBERRY TOWNSHIP DE PHYSICIAN ASSISTANT 2664 248 $44,640 $180 premium 100.0%
9 ARISING BEHAVIORAL HEALTH AND SERVICES LLC WASHINGTON DC NURSE PRACTITIONER 9 231 $43,890 $190 premium 100.0% (301) 792-9424
10 HUDSON MD GROUP FORT LEE NJ INTERNAL MEDICINE 107 196 $54,880 $280 premium 82.7% (201) 224-0011
11 WHOLE MIND LLC PLEASANT GROVE UT PSYCHIATRY 12 185 $32,556 $176 premium 100.0% (801) 477-7189
12 INTEGRATED REHAB CONSULTANTS CALIFORNIA INC LOS ANGELES CA PHYSICAL MEDICINE AND REHABILITATION 37 143 $28,833 $202 premium 3.0% (312) 635-0973
13 FIRST CHOICE MEDICAL CARE PLLC DYERSBURG TN INTERNAL MEDICINE 2 110 $20,885 $190 premium 84.6% (731) 285-7999
14 RONALD AUNG-DIN, M.D., P.A. SARASOTA FL NEUROLOGY 2 69 $10,871 $158 premium 100.0% (941) 342-9477
15 FRONTIER NEUROSCIENCES, LLC CODY WY INTERNAL MEDICINE 4 60 $13,320 $222 premium 100.0% (307) 578-1985
16 SEAGROVE MEDICAL CLINIC PA SEAGROVE NC FAMILY PRACTICE 2 34 $5,100 $150 premium 100.0% (336) 873-7248
17 CLIFFSIDE MEDICAL LLC CLIFFSIDE PARK NJ CARDIOVASCULAR DISEASE (CARDIOLOGY) 6 28 $7,000 $250 premium 11.8%
18 HUDSON MD GROUP FORT LEE NY INTERNAL MEDICINE 107 20 $5,600 $280 premium 52.6% (201) 224-0011
19 VANDERBILT HEALTH CLINICIANS, LLC NASHVILLE TN HEMATOLOGY/ONCOLOGY 130 20 $7,240 $362 premium 15.4% (615) 322-3000
20 WELLMED MEDICAL GROUP PA SAN ANTONIO TX NURSE PRACTITIONER 673 14 $3,872 $277 premium 1.7% (210) 523-1411
21 MID VALLEY COUNSELING CENTER INC SALEM OR CLINICAL PSYCHOLOGIST 11 13 $1,950 $150 premium 100.0% (503) 364-6093
22 TANANA VALLEY CLINIC LLC FAIRBANKS AK PHYSICIAN ASSISTANT 150 11 $6,479 $589 premium 100.0%

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →