NEVVI Medicare utilization intelligence
+ Build a code basket
Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
96113 Administration of developmental test, each additional 30 minutes CPT · E&M
Classification E&M › Behavioral Health Services (CMS RBCS)
First observed 2019
National scale 410 services ▲ 77.5% YoY · 114 beneficiaries (CY2024, Medicare FFS)
Medicare paid $19K · $47.05 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

4

Named groups billing this code
Named-group all-Medicare svcs · est.

643

Scaled from 410 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+71.9%

All-Medicare est. · observed FFS +77.5%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~643 services

410 observed fee-for-service (64%) · ~233 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 — 96113 (CY2024)
DE 248 OR 76 AK 65 TN 21

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

Billed → allowed → paid
Named-group submitted charges
$55K
Named-group allowed amount
$25K
Named-group Medicare payments
$19K
Avg charge / svc
$134
Avg allowed / svc
$60
Avg payment / svc
$47
Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.
Average charge per group
$77 4 groups · avg submitted charge / service $266
Market analyticsPlatform Methods →

Search a single state to see that market's full analytics — the free tier previews every panel, gated.

Or just look at it: nuclear heart imaging (78452) in Arizona is open as a live example — the full paid view, real data.

View the live example →
Unlock the Platform — the full read, every number below, code baskets, and export. Looking is free; the depth is paid. Notify me at launch →
Refine: group size any 5+ 25+ 100+ independent only
Filter results:

Email me this CSV

Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 96113 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 PHOENIX REHABILITATION AND HEALTH SERVICES INC CRANBERRY TOWNSHIP DE PHYSICIAN ASSISTANT 2664 248 $28,520 $115 100.0% —
2 MID VALLEY COUNSELING CENTER INC SALEM OR CLINICAL PSYCHOLOGIST 11 76 $5,850 $77 100.0% (503) 364-6093
3 TANANA VALLEY CLINIC LLC FAIRBANKS AK PHYSICIAN ASSISTANT 150 65 $17,290 $266 100.0% —
4 VANDERBILT HEALTH CLINICIANS, LLC NASHVILLE TN HEMATOLOGY/ONCOLOGY 130 21 $3,402 $162 100.0% (615) 322-3000

*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 →