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Market snapshot

99231 nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

99231 — Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes

Billing groups
5,126
Named-group FFS services
2,189,201
FFS of Medicare
49%
Services YoY
-11.9%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~4,410,876 services

2,189,201 observed fee-for-service (50%) · ~2,221,675 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; 2 states without payer-mix data excluded. How we scale

Top states — 99231 (CY2024)
FL 320,644 NY 262,846 TX 234,639 CA 221,562 PA 212,581

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

Named-group submitted charges
$266.6M
Named-group allowed amount
$102.6M
Named-group Medicare payments
$80.8M
Avg charge / svc
$122
Avg allowed / svc
$47
Avg payment / svc
$37
Average charge per group
$30 5,126 groups · avg submitted charge / service $3,547
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Specialty market — Psychiatry: 93,420 services across 146 groups; top group 10%. See Psychiatry across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
#Physician group City St Specialty Providers 99231 svcs Submitted charges Avg charge Medicare $ Share of specialty*Share of state* Phone
1 EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE, LLC PHILADELPHIA PA PSYCHIATRY 108 9,010 $865,795 $96 42.3% 4.2% (215) 487-4000
2 HMH CARRIER BEHAVIORAL HEALTH INC BELLE MEAD NJ PSYCHIATRY 45 4,682 $469,965 $100 32.2% 3.4% (908) 281-1000
3 BARNABAS HEALTH MEDICAL GROUP, PC NEWARK NJ PSYCHIATRY 254 3,459 $705,709 $204 23.8% 2.5% (973) 926-7814
4 STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL MORRIS PLAINS NJ PSYCHIATRY 127 2,653 $158,251 $60 18.3% 1.9% (973) 538-1800
5 STATE OF NEW HAMPSHIRE CONCORD NH PSYCHIATRY 77 2,609 $130,508 $50 — 11.4% (603) 271-5300
6 STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT STATE ACCOUNTING COLUMBUS OH PSYCHIATRY 111 2,387 $113,739 $48 — 2.2% (614) 752-0333
7 UHS OF HAMPTON INC WESTAMPTON NJ PSYCHIATRY 17 2,289 $249,270 $109 15.8% 1.6% (609) 267-7000
8 VIRGINIA SOUTH PSYCHIATRIC AND FAMILY SERVICES PETERSBURG VA PSYCHIATRY 35 2,177 $326,550 $150 — 2.8% (804) 861-0700
9 THE COMMONWEALTH OF MASSACHUSETTS TEWKSBURY MA PSYCHIATRY 147 2,160 $253,233 $117 — 1.4% (978) 851-7321
10 READING BEHAVIORAL HEALTHCARE, LLC READING PA PSYCHIATRY 16 1,943 $559,584 $288 9.1% 0.9% (484) 659-2300
11 THE MCLEAN HOSPITAL CORPORATION BELMONT MA PSYCHIATRY 185 1,891 $113,460 $60 — 1.3% (617) 855-3450
12 HAVEN BEHAVIORAL SERVICES OF PHILADELPHIA, LLC PHILADELPHIA PA PSYCHIATRY 6 1,802 $288,320 $160 8.5% 0.8% (215) 475-3400
13 WP ACQUISITION SUB LLC HAVERHILL MA PSYCHIATRY 9 1,619 $194,280 $120 — 1.1% (978) 556-6286
14 INSIGHT PHYSICIANS PC RICHMOND VA PSYCHIATRY 31 1,498 $299,600 $200 — 1.9% (804) 288-8282
15 HMH CARRIER BEHAVIORAL HEALTH INC BELLE MEAD FL PSYCHIATRY 45 1,464 $146,022 $100 21.5% 0.5% (908) 281-1000
16 MELROSEWAKEFIELD HEALTHCARE, INC MEDFORD MA PSYCHIATRY 27 1,408 $158,583 $113 — 0.9% —
17 PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES WERNERSVILLE PA PSYCHIATRY 32 1,399 $69,632 $50 6.6% 0.7% (610) 670-4100
18 MILLCREEK COMMUNITY HOSPITAL ERIE PA PSYCHIATRY 69 1,302 $100,361 $77 6.1% 0.6% (814) 454-3174
19 DISTRICT MEDICAL GROUP INC PHOENIX AZ PSYCHIATRY 466 1,230 $137,998 $112 — 3.5% (602) 914-1520
20 MONTGOMERY COUNTY MH-MR EMERGENCY SERVICE NORRISTOWN PA PSYCHIATRY 13 1,228 $159,640 $130 5.8% 0.6% (610) 279-6100
21 WILLIAM R SHARPE JR HOSPITAL WESTON WV PSYCHIATRY 20 1,209 $118,563 $98 — 4.2% (304) 269-1210
22 BELMONT BEHAVIORAL HOSPITAL LLC PHILADELPHIA PA PSYCHIATRY 11 1,203 $143,209 $119 5.7% 0.6% (215) 877-2000
23 DEPARTMENT OF STATE HOSPITALS NORWALK CA PSYCHIATRY 286 1,104 $65,554 $59 — 0.5% (916) 651-8811
24 PENNDEL MENTAL HEALTH CENTER, INC. PENNDEL PA PSYCHIATRY 7 1,055 $88,852 $84 5.0% 0.5% (215) 752-1541
25 STONY BROOK PSYCHIATRIC ASSOCIATES UNIVERSITY FACULTY PRACTICE CORPOR STONY BROOK NY PSYCHIATRY 99 1,005 $145,725 $145 19.1% 0.4% (631) 632-8850
26 ST JOSEPH'S HOSPITAL YONKERS HARRISON NY PSYCHIATRY 59 989 $109,198 $110 18.8% 0.4% (914) 967-6500
27 OGLETHORPE OF ORLANDO INC SAINT CLOUD FL PSYCHIATRY 2 987 $153,972 $156 14.5% 0.3% (321) 805-5090
28 UBH OF OREGON LLC PORTLAND OR PSYCHIATRY 22 977 $74,252 $76 — 3.4% (503) 944-5000
29 ALTAPOINTE HEALTH SYSTEMS INC MOBILE AL PSYCHIATRY 96 925 $83,520 $90 — 1.7% (251) 450-2211
30 BAYCARE BEHAVIORAL HEALTH ASSOCIATES, LLC LUTZ FL PSYCHIATRY 91 895 $112,335 $126 13.1% 0.3% (727) 281-9065
31 GRAYSON AND ASSOCIATES PC BIRMINGHAM AL PSYCHIATRY 65 892 $69,576 $78 — 1.6% (205) 323-6383
32 UHS OF HAMPTON INC WESTAMPTON PA PSYCHIATRY 17 780 $81,220 $104 3.7% 0.4% (609) 267-7000
33 VHM SERVICES INC FRAMINGHAM MA PSYCHIATRY 19 709 $77,281 $109 — 0.5% (508) 383-1012
34 STATE OF MISSOURI FULTON MO PSYCHIATRY 41 697 $26,910 $39 — 0.8% (573) 592-4100
35 ST JOHN'S MEDICAL SERVICES PC FAR ROCKAWAY NY PSYCHIATRY 97 655 $75,161 $115 12.5% 0.2% (718) 869-7919
36 ABMAYOR LLC SARASOTA FL PSYCHIATRY 3 652 $48,909 $75 9.6% 0.2% (618) 528-1244
37 CRESTWYN HEALTH GROUP, LLC MEMPHIS TN PSYCHIATRY 3 617 $55,530 $90 — 0.8% (901) 248-1500
38 SUMMIT BHC WEST VIRGINIA LLC CHARLESTON OH PSYCHIATRY 12 612 $48,960 $80 — 0.6% (304) 926-1600
39 WEST FLORIDA BEHAVIORAL HEALTH INC PENSACOLA FL PSYCHIATRY 16 605 $52,328 $86 8.9% 0.2% (850) 494-3953
40 CMC OF PA, PC ABINGTON PA PSYCHIATRY 10 599 $57,462 $96 2.8% 0.3% (215) 395-8266
41 UHS OF DOVER LLC DOVER DE PSYCHIATRY 9 596 $44,700 $75 — 2.9% (302) 741-0140
42 BOSTON UNIVERSITY PSYCHIATRY ASSOCIATES, INC. BOSTON MA PSYCHIATRY 98 579 $75,576 $131 — 0.4% (617) 414-5245
43 HEALTH AND HUMAN SERVICES COMMISSION TERRELL TX PSYCHIATRY 142 577 $27,695 $48 — 0.2% (972) 524-6452
44 EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE, LLC PHILADELPHIA DE PSYCHIATRY 108 534 $51,138 $96 — 2.6% (215) 487-4000
45 SHOALS HEALTH GROUP LLC MUSCLE SHOALS ND PSYCHIATRY 12 504 $39,312 $78 — 2.9% (256) 629-1062
46 COUNTY OF ESSEX CEDAR GROVE NJ PSYCHIATRY 11 494 $21,326 $43 3.4% 0.4% (973) 571-2833
47 HEALTHSOURCE SAGINAW INC SAGINAW MI PSYCHIATRY 15 486 $47,844 $98 — 0.4% (989) 790-7790
48 JEFFERSON PSYCHIATRIC ASSOCIATES LLC METAIRIE LA PSYCHIATRY 7 476 $47,600 $100 — 0.7% (504) 889-1448
49 UNIVERSITY BEHAVIORAL LLC ORLANDO FL PSYCHIATRY 3 474 $33,180 $70 7.0% 0.1% (407) 281-7000
50 BRENTWOOD ACQUISITION-SHREVEPORT INC SHREVEPORT LA PSYCHIATRY 13 472 $59,000 $125 — 0.7% (318) 678-7500
51 MOUNT AUBURN HOSPITAL CAMBRIDGE MA PSYCHIATRY 7 456 $40,584 $89 — 0.3% (617) 499-5054
52 ARBOUR INC BOSTON MA PSYCHIATRY 21 453 $58,890 $130 — 0.3% (617) 522-4400
53 SPECIALTY PHYSICIANS OF ILLINOIS LLC OLYMPIA FIELDS IL PSYCHIATRY 112 429 $40,489 $94 — 0.4% (844) 740-4445
54 SUMMIT OAKS HOSPITAL INC SUMMIT NJ PSYCHIATRY 12 428 $51,360 $120 2.9% 0.3% (908) 522-7000
55 DEPARTMENT OF SOCIAL DEPT OF SHS DIV OF INSTNS MEDICAL LAKE WA PSYCHIATRY 25 413 $178,396 $432 — 0.9% (509) 565-4000
56 HMH CARRIER BEHAVIORAL HEALTH INC BELLE MEAD NY PSYCHIATRY 45 404 $41,207 $102 7.7% 0.2% (908) 281-1000
57 ALEGENT CREIGHTON HEALTH OMAHA NE PSYCHIATRY 137 400 $54,466 $136 — 1.5% (402) 572-2905
58 LAUREATE PSYCHIATRIC CLINIC AND HOSPITAL INC TULSA OK PSYCHIATRY 81 398 $40,089 $101 — 1.1% (918) 481-4000
59 WEKIVA SPRINGS CENTER LLC JACKSONVILLE GA PSYCHIATRY 8 393 $39,384 $100 — 0.5% (904) 296-3533
60 WEKIVA SPRINGS CENTER LLC JACKSONVILLE NY PSYCHIATRY 8 390 $39,018 $100 7.4% 0.1% (904) 296-3533
61 ASANA INTEGRATED MEDICAL GROUP PC SANTA ROSA CA PSYCHIATRY 25 384 $53,760 $140 — 0.2% (844) 496-9160
62 WP ACQUISITION SUB LLC HAVERHILL NY PSYCHIATRY 9 375 $45,000 $120 7.1% 0.1% (978) 556-6286
63 WISCONSIN AVE PSYCHIATRIC CENTER INC WASHINGTON DC PSYCHIATRY 9 368 $36,800 $100 — 4.5% (202) 965-8550
64 SONORA BEHAVIORAL HEALTH HOSPITAL LLC TUCSON AZ PSYCHIATRY 9 359 $56,375 $157 — 1.0% (520) 469-8700
65 THREE RIVERS BEHAVIORAL HEALTH LLC WEST COLUMBIA SC PSYCHIATRY 10 346 $29,410 $85 — 0.6% (803) 796-9911
66 SOUTH BEND PSYCHIATRY LLC PLYMOUTH IN PSYCHIATRY 3 338 $23,660 $70 — 0.5% (574) 303-5375
67 CEP AMERICA - PSYCHIATRY PC COLTON CA PSYCHIATRY 90 335 $278,665 $832 — 0.2% (909) 580-1000
68 STATE OF SOUTH DAKOTA YANKTON SD PSYCHIATRY 6 322 $13,230 $41 — 2.6% (605) 668-3107
69 SHOALS HEALTH GROUP LLC MUSCLE SHOALS AL PSYCHIATRY 12 322 $25,116 $78 — 0.6% (256) 629-1062
70 PROSPECT MANCHESTER HOSPITAL INC MANCHESTER CT PSYCHIATRY 21 321 $43,772 $136 — 0.6% (860) 646-1222
71 COUNTY OF TREMPEALEAU INDEPENDENCE WI PSYCHIATRY 3 318 $18,762 $59 — 0.7% (715) 538-4312
72 COMPREHENSIVE COUNSELING CENTER PC WARREN MI PSYCHIATRY 3 307 $31,930 $104 — 0.3% (586) 558-6000
73 PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES WERNERSVILLE NY PSYCHIATRY 32 306 $14,522 $47 5.8% 0.1% (610) 670-4100
74 2014 HEALTH LLC DES PLAINES IL PSYCHIATRY 22 296 $36,600 $124 — 0.3% (212) 243-5565
75 STATE OF NEW HAMPSHIRE CONCORD TX PSYCHIATRY 77 289 $14,436 $50 — 0.1% (603) 271-5300
76 STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT KALAMAZOO MI PSYCHIATRY 21 287 $20,869 $73 — 0.3% (616) 337-3413
77 HAVEN BEHAVIORAL SERVICES OF WEST CHESTER LLC WEST CHESTER PA PSYCHIATRY 19 280 $29,025 $104 1.3% 0.1% (484) 835-2050
78 COUNTY OF TULARE VISALIA CA PSYCHIATRY 32 270 $15,741 $58 — 0.1% (559) 623-0900
79 UHS OKLAHOMA CITY LLC BETHANY OK PSYCHIATRY 5 266 $28,728 $108 — 0.7% (918) 625-7167
80 CENTERSTONE OF FLORIDA INC BRADENTON FL PSYCHIATRY 37 256 $38,400 $150 3.8% 0.1% (941) 782-4150
81 IHA OLMA SPECIALTY 1 LLC LIVONIA MI PSYCHIATRY 71 255 $25,035 $98 — 0.2% (734) 655-2692
82 CEDAR SPRINGS HOSPITAL, INC COLORADO SPRINGS CO PSYCHIATRY 11 249 $14,940 $60 — 1.0% (719) 633-4114
83 STATE OF ALASKA DEPARTMENT OF ADMINISTRATION ANCHORAGE AK PSYCHIATRY 14 248 $20,415 $82 — 2.5% (907) 269-7100
84 SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE COLUMBIA SC PSYCHIATRY 237 247 $11,263 $46 — 0.4% (803) 898-8579
85 STATE OF ARKANSAS LITTLE ROCK AR PSYCHIATRY 19 243 $39,768 $164 — 0.4% (501) 686-9585
86 CEDAR CREST CLINIC BELTON TX PSYCHIATRY 7 238 $28,560 $120 — 0.1% —
87 STATE OF NEW JERSEY OMB CENTRALIZED PAYROLL MORRIS PLAINS NY PSYCHIATRY 127 226 $15,224 $67 4.3% 0.1% (973) 538-1800
88 ST JOSEPHS HEALTHCARE INC PATERSON NJ PSYCHIATRY 21 218 $28,023 $129 1.5% 0.2% (973) 754-4750
89 FOCUS MENTAL HEALTH SOLUTIONS BHUSHAN MANJOORAN WIRJO PLLC HENDERSON NV PSYCHIATRY 21 215 $19,565 $91 — 0.7% (702) 790-2701
90 COUNTY OF HUMBOLDT EUREKA MT PSYCHIATRY 22 214 $141,927 $663 — 1.6% (707) 441-5466
91 LA AMISTAD RESIDENTIAL TREATMENT CENTER LLC ORLANDO FL PSYCHIATRY 3 202 $14,140 $70 3.0% 0.1% (407) 370-0111
92 MILDRED MITCHELL BATEMAN HOSPITAL HUNTINGTON WV PSYCHIATRY 5 201 $19,674 $98 — 0.7% (304) 525-7801
93 ABS LINCS KY, LLC. HOPKINSVILLE VA PSYCHIATRY 8 199 $17,870 $90 — 0.3% (270) 886-1919
94 KMI ACQUISITION LLC LOUISVILLE KY PSYCHIATRY 4 198 $13,860 $70 — 0.3% (502) 426-6380
95 ROLLING HILLS HOSPITAL LLC FRANKLIN TN PSYCHIATRY 7 198 $19,800 $100 — 0.2% —
96 MOIEZ KHANKHANIAN, M.D. INC ROSEMEAD CA PSYCHIATRY 3 185 $18,620 $101 — 0.1% (626) 813-1222
97 DOUGLAS COUNTY NEBRASKA OMAHA NE PSYCHIATRY 12 181 $15,313 $85 — 0.7% (402) 444-7000
98 ACADIA NEURO-BEHAVIORAL ASSOCIATES PA PEMBROKE PINES FL PSYCHIATRY 2 175 $43,750 $250 2.6% 0.1% (954) 436-5000
99 DISTRICT MEDICAL GROUP INC PHOENIX NY PSYCHIATRY 466 173 $19,049 $110 3.3% 0.1% (602) 914-1520
100 MCCD FL PSYCHIATRY SERVICES PA MCKINNEY IA PSYCHIATRY 653 162 $26,919 $166 — 0.4% (917) 634-5311

Showing the top 100 of 5,126 groups — the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*"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 →