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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
96159 Treatment of behavior impacting health, each additional 15 minutes CPT · E&M
Classification E&M › Behavioral Health Services (CMS RBCS)
First observed 2020
National scale 14,163 services ▼ 22.3% YoY · 2,115 beneficiaries (CY2024, Medicare FFS)
Medicare paid $232K · $16.41 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
48
Named-group FFS services
9,497
FFS of Medicare
49%
Services YoY
-22.3%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~19,816 services

9,497 observed fee-for-service (48%) · ~10,319 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 — 96159 (CY2024)
CA 4,096 WI 1,301 TN 1,031 MD 888 CO 817

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

Named-group submitted charges
$948K
Named-group allowed amount
$198K
Named-group Medicare payments
$152K
Avg charge / svc
$100
Avg allowed / svc
$21
Avg payment / svc
$16
Average charge per group
$30 48 groups · avg submitted charge / service $312
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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers 96159 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC MADISON WI PHYSICIAN ASSISTANT 2523 1,047 $182,178 $174 80.5% (608) 287-2050
2 VANDERBILT UNIVERSITY MEDICAL CENTER NASHVILLE TN NURSE PRACTITIONER 3394 818 $49,080 $60 79.3% (615) 322-5000
3 UNIVERSITY PHYSICIANS INCORPORATED AURORA CO PHYSICIAN ASSISTANT 3122 760 $79,427 $105 93.0% (720) 777-1234
4 JOHNS HOPKINS UNIVERSITY BALTIMORE MD NURSE PRACTITIONER 2900 748 $53,890 $72 84.2% (410) 502-4340
5 FACULTY PHYSICIANS AND SURGEONS OF LLUSM LOMA LINDA CA DIAGNOSTIC RADIOLOGY 1317 541 $37,870 $70 13.2% —
6 MAYO CLINIC JACKSONVILLE JACKSONVILLE FL NURSE PRACTITIONER 1587 492 $49,200 $100 86.2% (904) 953-2000
7 HEALTH PSYCH MAINE LLC WATERVILLE ME CLINICAL PSYCHOLOGIST 10 403 $16,078 $40 82.2% (207) 872-5800
8 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 370 $115,597 $312 9.0% (650) 723-4000
9 NORTHERN ARIZONA HEALTHCARE CORPORATION FLAGSTAFF AZ PHYSICIAN ASSISTANT 395 344 $19,952 $58 77.5% (928) 773-2249
10 SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA INTERNAL MEDICINE 3716 245 $26,705 $109 6.0% (415) 600-1020
11 NORTHWESTERN MEDICAL FACULTY FOUNDATION CHICAGO IL NURSE PRACTITIONER 4339 209 $13,167 $63 31.0% —
12 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 201 $24,723 $123 34.5% (507) 284-2511
13 BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC BOSTON MA PHYSICIAN ASSISTANT 2942 183 $14,949 $82 100.0% (617) 732-5500
14 UNIVERSITY HOSPITALS MEDICAL GROUP INC CLEVELAND OH NURSE PRACTITIONER 2232 172 $9,460 $55 64.7% —
15 UNIVERSITY OF PITTSBURGH PHYSICIANS PITTSBURGH PA DIAGNOSTIC RADIOLOGY 4291 168 $15,919 $95 32.5% —
16 SPECIALISTS IN PAIN MANAGEMENT, PLLC DBA SPINE AND PAIN ASSOCIATES CHATTANOOGA TN NURSE PRACTITIONER 31 168 $11,776 $70 16.3% (423) 698-0850
17 FAIRVIEW EXPRESS CARE MINNEAPOLIS MN PHYSICIAN ASSISTANT 2007 167 $14,377 $86 28.6% (612) 672-7422
18 MNGI DIGESTIVE HEALTH PA MINNEAPOLIS MN GASTROENTEROLOGY 277 163 $13,529 $83 28.0% (612) 871-1145
19 ACCESS PSYCHOLOGY SERVICES PC FRESNO CA CLINICAL PSYCHOLOGIST 17 142 $4,260 $30 3.5% (559) 321-0883
20 COLUMBIA ST MARYS HOSPITAL MILWAUKEE INC MILWAUKEE WI PHYSICIAN ASSISTANT 325 131 $9,275 $71 10.1% (414) 585-1000
21 SHEPHERD CENTER, INC. ATLANTA GA PHYSICAL MEDICINE AND REHABILITATION 49 130 $14,117 $109 100.0% (404) 352-2020
22 STATE OF CONNECTICUT FARMINGTON CT PSYCHIATRY 267 128 $7,076 $55 100.0% (860) 679-2000
23 UCSF MEDICAL GROUP BUSINESS SERVICES SAN FRANCISCO CA DIAGNOSTIC RADIOLOGY 1548 126 $15,498 $123 3.1% (415) 476-1000
24 UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL MADISON WI DIAGNOSTIC RADIOLOGY 111 123 $21,402 $174 9.5% (608) 265-8731
25 SWEDISH HEALTH SERVICES SEATTLE WA PHYSICIAN ASSISTANT 1033 122 $7,564 $62 100.0% —
26 LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER PORTLAND OR CARDIOVASCULAR DISEASE (CARDIOLOGY) 194 117 $6,903 $59 17.8% (503) 413-7022
27 SKY LAKES MEDICAL CENTER INC KLAMATH FALLS OR PHYSICIAN ASSISTANT 197 109 $5,396 $50 16.6% (541) 274-6221
28 UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL CHAPEL HILL NC NURSE PRACTITIONER 2120 103 $6,798 $66 71.5% (984) 215-5556
29 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 94 $15,322 $163 35.3% —
30 MAYO CLINIC ARIZONA PHOENIX AZ PHYSICIAN ASSISTANT 1635 88 $11,880 $135 19.8% (800) 603-0558
31 EASTERN MAINE MEDICAL CENTER BANGOR ME PHYSICIAN ASSISTANT 697 87 $9,244 $106 17.8% (207) 973-7000
32 PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA MIAMI FL NURSE PRACTITIONER 450 79 $3,160 $40 13.8% (305) 585-1111
33 UNIVERSITY PROFESSIONAL SERVICES PORTLAND OR PHYSICIAN ASSISTANT 1717 71 $4,945 $70 10.8% (503) 494-8311
34 MID-VALLEY HEALTHCARE INC LEBANON OR FAMILY PRACTICE 141 65 $4,818 $74 9.9% (541) 451-7200
35 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 61 $4,390 $72 1.5% (858) 455-9100
36 CENTRACARE CLINIC SAINT CLOUD MN PHYSICIAN ASSISTANT 747 52 $4,302 $83 8.9% (320) 252-5131
37 THE REGENTS OF THE UNIVERSITY OF CALIFORNIA LOS ANGELES CA INTERNAL MEDICINE 1424 50 $6,014 $120 1.2% (310) 825-7922
38 ALBERT EINSTEIN MEDICAL CENTER ELKINS PARK PA CLINICAL PSYCHOLOGIST 5 49 $3,038 $62 9.5% (215) 663-6000
39 ABILITY KC KANSAS CITY MO FAMILY PRACTICE 161 47 $5,370 $114 100.0% (816) 751-7832
40 UNIVERSITY OF CALIFORNIA SAN FRANCISCO SAN FRANCISCO CA DIAGNOSTIC RADIOLOGY 1842 46 $5,658 $123 1.1% (415) 476-4029
41 CARLE HEALTH CARE INCORPORATED URBANA IL NURSE PRACTITIONER 1528 44 $4,092 $93 6.5% (888) 712-2753
42 THE NEUROCOGNITIVE INSTITUTE LLC MOUNT ARLINGTON NJ CLINICAL PSYCHOLOGIST 7 43 $2,084 $48 100.0% (973) 601-0100
43 UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, PC BIRMINGHAM AL NURSE PRACTITIONER 2788 43 $2,128 $50 100.0% (205) 934-3460
44 PROVIDENCE HEALTH AND SERVICES MT MISSOULA MT PHYSICIAN ASSISTANT 345 40 $2,720 $68 100.0% (406) 327-1900
45 COUNTY OF SANTA CLARA SAN JOSE CA INTERNAL MEDICINE 1001 37 $7,032 $190 0.9% (408) 885-5000
46 CHEYENNE REGIONAL PHYSICIANS GROUP LLC CHEYENNE CO NURSE PRACTITIONER 103 32 $2,287 $71 3.9% (307) 635-7961
47 EVOLUTIS LLC CHICAGO CO CLINICAL PSYCHOLOGIST 8 25 $2,825 $113 3.1% (877) 219-8726
48 DAVID SPANGLER PHD INC ROSEVILLE CA CLINICAL PSYCHOLOGIST 2 14 $735 $52 0.3% (530) 613-8131

*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 →