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Market snapshot

98967 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

98967 — Telephone medical discussion provided by nonphysician professional, 11-20 minutes

Billing groups
45
Named-group FFS services
2,596
FFS of Medicare
49%
Services YoY
-15.5%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~5,333 services

2,596 observed fee-for-service (49%) · ~2,737 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 — 98967 (CY2024)
CA 1,066 TX 305 FL 287 VA 250 LA 209

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

Named-group submitted charges
$165K
Named-group allowed amount
$56K
Named-group Medicare payments
$41K
Avg charge / svc
$63
Avg allowed / svc
$21
Avg payment / svc
$16
Average charge per group
$21 45 groups · avg submitted charge / service $208
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City St Specialty Providers 98967 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 WELLSPRING PSYCHOLOGICAL SERVICES INC MONTEREY CA CLINICAL PSYCHOLOGIST 16 524 $15,196 $29 49.2% (831) 647-8490
2 WELLSPRING PSYCHOLOGICAL SERVICES INC MONTEREY LA CLINICAL PSYCHOLOGIST 16 209 $6,061 $29 100.0% (831) 647-8490
3 HIGH DESERT MEDICAL CORPORATION LANCASTER CA NURSE PRACTITIONER 59 111 $4,773 $43 10.4% (661) 945-5984
4 HEALTHTEXAS PROVIDER NETWORK DALLAS TX PHYSICIAN ASSISTANT 2482 111 $9,717 $88 36.4% —
5 STANFORD HEALTH CARE STANFORD CA DIAGNOSTIC RADIOLOGY 3039 109 $13,189 $121 10.2% (650) 723-4000
6 CENTER FOR UROLOGIC CARE OF BERKS CO PC READING PA UROLOGY 16 102 $6,008 $59 82.3% (610) 372-8995
7 HARTFORD HEALTHCARE MEDICAL GROUP SPECIALISTS PLLC STORRS CT PHYSICIAN ASSISTANT 1493 100 $9,420 $94 73.5% (860) 724-2579
8 PIONEER MEDICAL ASSOCIATES PLLC FRISCO TX NURSE PRACTITIONER 6 91 $4,550 $50 29.8% (469) 888-4890
9 NY SOCIETY FOR THE RELIEF OF RUPTURED AND CRIPPLED MAINTAINING NEW YORK NY PHYSICIAN ASSISTANT 174 90 $9,900 $110 43.3% (516) 240-2700
10 DELAWARE MEDICAL ASSOCIATES PA WILMINGTON DE INTERNAL MEDICINE 4 85 $2,550 $30 100.0% (302) 234-2200
11 PROVIDENCE MEDICAL FOUNDATION FULLERTON CA PHYSICIAN ASSISTANT 1455 81 $6,273 $77 7.6% (714) 871-3006
12 SCOTT AND WHITE CLINIC TEMPLE TX PHYSICIAN ASSISTANT 2435 71 $6,319 $89 23.3% (254) 724-2663
13 MECNB LLC TEQUESTA FL PHYSICIAN ASSISTANT 26 70 $7,000 $100 24.4% (561) 747-4464
14 CORA HEALTH SERVICES INC THE VILLAGES FL ORTHOPEDIC SURGERY 1187 62 $2,418 $39 21.6% (352) 693-3378
15 JAMES RIVER CARDIOLOGY, LLC COLONIAL HEIGHTS VA PHYSICIAN ASSISTANT 49 59 $3,981 $67 23.6% (804) 520-1764
16 NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED AND CRIPPLED MAINTAINING NEW YORK NY PHYSICIAN ASSISTANT 112 44 $4,840 $110 21.2% (212) 774-7598
17 INTEGRATED PAIN MANAGEMENT MEDICAL GROUP INC WALNUT CREEK CA PHYSICAL MEDICINE AND REHABILITATION 40 35 $4,235 $121 3.3% (925) 482-8151
18 BIO ENERGY MEDICAL CENTER, PC ANN ARBOR MI NURSE PRACTITIONER 3 34 $714 $21 37.0% (734) 995-3200
19 OPTUMCARE NEW MEXICO LLC ALBUQUERQUE NM FAMILY PRACTICE 71 33 $1,815 $55 100.0% (505) 275-4288
20 STAT CARDIOLOGIST INC SCHAUMBURG IL NURSE PRACTITIONER 27 33 $1,650 $50 36.7% (847) 490-0060
21 UNIVERSITY MEDICAL ASSOCIATES OF THE MEDICAL UNIVERSITY OF SOUTH CAROL CHARLESTON SC PHYSICIAN ASSISTANT 1692 30 $3,230 $108 100.0% (843) 792-1414
22 PROVIDENCE HEALTH AND SERVICES WASHINGTON SPOKANE WA PHYSICIAN ASSISTANT 771 30 $2,220 $74 68.2% —
23 RECOVERY MOBILE CLINIC WHITE LAKE MI NURSE PRACTITIONER 4 27 $1,269 $47 29.3% (248) 563-5735
24 CALIFORNIA CANCER ASSOCIATES FOR RESEARCH AND EXCELLENCE INC FRESNO CA HEMATOLOGY/ONCOLOGY 62 27 $1,728 $64 2.5% (559) 326-1222
25 WILLAMETTE COMMUNITY HEALTH SOLUTIONS EUGENE OR PHYSICAL THERAPIST IN PRIVATE PRACTICE 29 27 $1,830 $68 100.0% (541) 342-1632
26 KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC LARGO MD INTERNAL MEDICINE 1965 27 $2,106 $78 69.2% (301) 618-5700
27 CENTRAL ARKANSAS RADIATION THERAPY INSTITUTE INC LITTLE ROCK AR HEMATOLOGY/ONCOLOGY 90 26 $5,408 $208 52.0% —
28 NORTHERN ARIZONA HEALTHCARE CORPORATION FLAGSTAFF AZ PHYSICIAN ASSISTANT 395 25 $1,700 $68 31.6% (928) 773-2249
29 HOSPICE OF THE PIEDMONT, INC. CHARLOTTESVILLE VA NURSE PRACTITIONER 8 23 $1,054 $46 9.2% (434) 817-6900
30 NY SOCIETY FOR THE RELIEF OF RUPTURED AND CRIPPLED MAINTAINING NEW YORK PA PHYSICIAN ASSISTANT 174 22 $2,420 $110 17.7% (516) 240-2700
31 PETALUMA HEALTH CENTER INC PETALUMA CA FAMILY PRACTICE 72 21 $1,659 $79 2.0% (707) 559-7500
32 MERCY HEALTH PHYSICIANS-NORTH LLC TOLEDO OH FAMILY PRACTICE 135 21 $903 $43 100.0% —
33 ALGOS INC A MEDICAL CORPORATION PASADENA CA PHYSICAL MEDICINE AND REHABILITATION 24 20 $1,600 $80 1.9% (626) 403-6200
34 SETON FAMILY OF DOCTORS AUSTIN TX PHYSICIAN ASSISTANT 804 20 $1,680 $84 6.6% (512) 324-7300
35 RUSHFORD CENTER INC MERIDEN CT NURSE PRACTITIONER 25 19 $1,648 $87 14.0% (203) 630-5220
36 AFFILIATED HOSPITALISTS PLC PHOENIX AZ INTERNAL MEDICINE 84 18 $2,500 $139 22.8% (602) 445-0751
37 RWJBH PRIMARY CARE SERVICES WARREN NJ INTERNAL MEDICINE 264 17 $765 $45 50.0% —
38 GREAT MIND COUNSELING AND WELLNESS CENTER LLC LAS VEGAS NV NURSE PRACTITIONER 3 16 $378 $24 100.0% (702) 208-2194
39 RIDGEVIEW MEDICAL CENTER WACONIA MN DIAGNOSTIC RADIOLOGY 412 16 $1,280 $80 100.0% (952) 442-2191
40 CANCER CENTER OF MIDDLE GEORGIA, LLC DUBLIN GA NURSE PRACTITIONER 4 16 $1,152 $72 23.9% (941) 404-1851
41 SUTTER BAY MEDICAL FOUNDATION PALO ALTO CA INTERNAL MEDICINE 3716 16 $1,600 $100 1.5% (415) 600-1020
42 HOSPITAL PHYSICIAN SERVICES OF FLORIDA PA TALLAHASSEE FL INTERNAL MEDICINE 224 14 $504 $36 4.9% (850) 325-5000
43 OKANOGAN COUNTY PUBLIC HOSPITAL DISTRICT NO. 3 OMAK WA DIAGNOSTIC RADIOLOGY 88 14 $1,750 $125 31.8% (509) 826-1760
44 PROVIDENCE HEALTH AND SERVICES MT MISSOULA MT PHYSICIAN ASSISTANT 345 14 $1,036 $74 50.0% (406) 327-1900
45 DUPAGE MEDICAL GROUP LTD GLEN ELLYN IL PHYSICIAN ASSISTANT 1323 12 $1,068 $89 13.3% (630) 469-9200
46 MARY WASHINGTON HEALTHCARE PHYSICIANS FREDERICKSBURG VA PHYSICIAN ASSISTANT 307 12 $600 $50 4.8% (540) 741-1100
47 MEDSTAR MEDICAL GROUP II LLC WASHINGTON MD PHYSICIAN ASSISTANT 3707 12 $876 $73 30.8% (202) 429-2401

*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 →