NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
96165 Treatment of behavior impacting health in group setting, each additional 30 minutes CPT · E&M
Classification E&M Behavioral Health Services Psychotherapy - Group (CMS RBCS)
First observed 2020
National scale 28,822 services ▼ 9.0% YoY · 1,966 beneficiaries (CY2024, Medicare FFS)
Medicare paid $88K · $3.06 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
23
Named-group FFS services
26,851
FFS of Medicare
49%
Services YoY
-9.0%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~57,977 services

26,851 observed fee-for-service (46%) · ~31,126 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 — 96165 (CY2024)

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

Named-group submitted charges
$1.9M
Named-group allowed amount
$108K
Named-group Medicare payments
$83K
Avg charge / svc
$71
Avg allowed / svc
$4
Avg payment / svc
$3
Average charge per group
$5 23 groups · avg submitted charge / service $112
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 96165 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 96165 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 MAYO CLINIC ARIZONA PHOENIX AZ PHYSICIAN ASSISTANT 1635 8,164 $644,956 $79 premium 94.7% (800) 603-0558
2 MAYO CLINIC JACKSONVILLE JACKSONVILLE FL NURSE PRACTITIONER 1587 6,448 $722,176 $112 premium 100.0% (904) 953-2000
3 MAYO CLINIC ROCHESTER MN NURSE PRACTITIONER 4896 4,482 $327,186 $73 premium 100.0% (507) 284-2511
4 UNIVERSITY OF CALIFORNIA SAN FRANCISCO SAN FRANCISCO CA DIAGNOSTIC RADIOLOGY 1842 1,287 $34,619 $27 premium 35.2% (415) 476-4029
5 UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC MADISON WI PHYSICIAN ASSISTANT 2523 994 $40,257 $40 premium 51.1% (608) 287-2050
6 FORM HEALTH ASSOCIATES PC BAKERSFIELD CA FAMILY PRACTICE 8 950 $4,655 $5 premium 26.0% (617) 505-1520
7 MARY HITCHCOCK MEMORIAL HOSPITAL LEBANON NH NURSE PRACTITIONER 1270 560 $6,870 $12 premium 100.0% (603) 650-5000
8 STATE UNIVERSITY OF IOWA IOWA CITY IA PHYSICIAN ASSISTANT 1902 534 $8,010 $15 premium 100.0% (319) 678-8201
9 VANDERBILT UNIVERSITY MEDICAL CENTER NASHVILLE TN NURSE PRACTITIONER 3394 512 $43,520 $85 premium 87.5% (615) 322-5000
10 CLEVELAND CLINIC CLEVELAND OH PHYSICIAN ASSISTANT 6828 458 $15,114 $33 premium 100.0%
11 NORTHERN ARIZONA HEALTHCARE CORPORATION FLAGSTAFF AZ PHYSICIAN ASSISTANT 395 457 $5,484 $12 premium 5.3% (928) 773-2249
12 UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL MADISON WI DIAGNOSTIC RADIOLOGY 111 316 $12,798 $40 premium 16.3% (608) 265-8731
13 VIRGINIA MASON MEDICAL CENTER SEATTLE WA PHYSICIAN ASSISTANT 879 302 $7,852 $26 premium 48.9% (206) 223-6600
14 THE ASSOCIATION OF UNIVERSITY PHYSICIANS SEATTLE WA PHYSICIAN ASSISTANT 3612 271 $3,390 $13 premium 43.9% (206) 364-0500
15 UNIVERSITY OF UTAH BEHAVIORAL HEALTH SERVICES SALT LAKE CITY UT PSYCHIATRY 184 189 $2,538 $13 premium 70.8% (801) 581-2121
16 MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION INC LA CROSSE CO FAMILY PRACTICE 547 179 $8,950 $50 premium 100.0% (608) 785-0940
17 UC REGENTS LOS ANGELES CA PSYCHIATRY 142 172 $3,512 $20 premium 4.7% (310) 825-9111
18 LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER PORTLAND OR CARDIOVASCULAR DISEASE (CARDIOLOGY) 194 162 $6,561 $40 premium 56.8% (503) 413-7022
19 MASS GENERAL BRIGHAM MEDICAL GROUP SUBURBAN MASSACHUSETTS INC NEWTON CT INTERNAL MEDICINE 535 107 $1,823 $17 premium 100.0% (617) 243-6000
20 ALBERT EINSTEIN MEDICAL CENTER ELKINS PARK PA CLINICAL PSYCHOLOGIST 5 80 $1,440 $18 premium 100.0% (215) 663-6000
21 BEHAVIORAL MEDICINE INSTITUTE PC KNOXVILLE TN CLINICAL PSYCHOLOGIST 21 73 $511 $7 premium 12.5% (865) 264-2400
22 MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION INC LA CROSSE WI FAMILY PRACTICE 547 72 $3,600 $50 premium 3.7% (608) 785-0940
23 SWEDISH HEALTH SERVICES SEATTLE WA PHYSICIAN ASSISTANT 1033 44 $572 $13 premium 7.1%
24 PEACEHEALTH MEDICAL GROUP EUGENE OR NURSE PRACTITIONER 259 38 $456 $12 premium 13.3% (541) 222-8700

*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 →