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Market snapshot

99214 in NJ CY2024

Medicare Part B FFS · CY2024 · as published by CMS

99214 — Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more

Billing groups
1,475
Named-group FFS services
2,476,179
FFS of Medicare
59%
Services YoY
+5.2%
FFS enrollment -0.7%
Estimated all-Medicare volume FFS + estimated MA estimate
~4,147,603 services

2,476,179 observed fee-for-service (60%) · ~1,671,424 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

Named-group submitted charges
$819.3M
Named-group allowed amount
$323.4M
Named-group Medicare payments
$230.3M
Avg charge / svc
$331
Avg allowed / svc
$131
Avg payment / svc
$93
Average charge per group
$98 1,475 groups · avg submitted charge / service $1,742
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Specialty market — Pulmonary Disease: 15,233 services across 11 groups; top group 25%. See Pulmonary Disease across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 99214 services, CY2024
#Physician group City Specialty Providers 99214 svcs Submitted charges Avg charge Medicare $ locked column Share of specialty*Share of state* Phone
1 OCEAN PULMONARY ASSOCIATES, P.A. TOMS RIVER PULMONARY DISEASE 9 3,739 $1,588,745 $425 premium 24.5% 0.1% (732) 341-1380
2 SHORE PULMONARY, PA BRICK PULMONARY DISEASE 18 3,538 $684,445 $193 premium 23.2% 0.1% (732) 775-9075
3 HOLY NAME PULMONARY ASSOCIATES PC ENGLEWOOD PULMONARY DISEASE 15 3,191 $1,355,855 $425 premium 20.9% 0.1% (201) 871-3636
4 RESPACARE PA BRIDGEWATER PULMONARY DISEASE 2 1,883 $1,306,253 $694 premium 12.4% 0.1% (732) 356-9950
5 HACKENSACK SLEEP AND PULMONARY CENTER LLC. HACKENSACK PULMONARY DISEASE 2 919 $230,000 $250 premium 6.0% 0.0% (201) 996-0232
6 CENTRAL JERSEY PULMONARY AND MEDICAL ASSOCIATES, LLC HOLMDEL PULMONARY DISEASE 2 685 $115,087 $168 premium 4.5% 0.0% (732) 264-1001
7 SOMERSET PULMONARY AND CRITICAL CARE ASSOCIATES, PA BRIDGEWATER PULMONARY DISEASE 3 499 $86,987 $174 premium 3.3% 0.0% (908) 722-5115
8 TANUJ BHATNAGAR MD LLC JERSEY CITY PULMONARY DISEASE 2 261 $57,682 $221 premium 1.7% 0.0% (201) 636-5050
9 NORTH JERSEY PULMONARY ASSOCIATES RIDGEWOOD PULMONARY DISEASE 3 214 $54,614 $255 premium 1.4% 0.0% (973) 321-1670
10 PULMONARY AND SLEEP ASSOCIATES OF MERCER-BUCKS MONROE TOWNSHIP PULMONARY DISEASE 3 153 $54,822 $358 premium 1.0% 0.0% (609) 710-5526
11 PULMONARY CRITICAL CARE AND SLEEP PHYSICIANS OF THE MAIN LINE PC MEDIA PULMONARY DISEASE 7 151 $26,425 $175 premium 1.0% 0.0% (484) 442-8235

*"Share of specialty" is the group's share of disclosed Medicare-FFS services for the primary code among groups with the SAME modal specialty in the state; "share of state" is the same figure against the whole state. Specialty is each group's modal member specialty from CMS's clinician register — a multi-specialty group carries one label. Where fewer than 11 groups share the specialty in the state, the specialty share renders "—" — the specialty benchmark is suppressed (fewer than 11 groups) and the state share alongside is the benchmark. Group figures sum clinicians affiliated with exactly one group. 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 →