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Market snapshot

99285 in DE CY2024

Medicare Part B FFS · CY2024 · as published by CMS

99285 — Emergency department visit with high level of medical decision making

Billing groups
39
Named-group FFS services
24,415
FFS of Medicare
67%
Services YoY
-13.0%
FFS enrollment -0.5%
Estimated all-Medicare volume FFS + estimated MA estimate
~35,850 services

24,415 observed fee-for-service (68%) · ~11,435 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
$27.1M
Named-group allowed amount
$4.1M
Named-group Medicare payments
$3.2M
Avg charge / svc
$1,110
Avg allowed / svc
$170
Avg payment / svc
$131
Average charge per group
$365 39 groups · avg submitted charge / service $1,850
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Specialty market — Emergency Medicine: 13,409 services across 21 groups; top group 55%. See Emergency Medicine across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 99285 services, CY2024
#Physician group City Specialty Providers 99285 svcs Submitted charges Avg charge Medicare $ locked column Share of specialty*Share of state* Phone
1 BAYHEALTH EMERGENCY PHYSICIANS LLC DOVER EMERGENCY MEDICINE 75 7,347 $8,688,554 $1,183 premium 54.8% 16.1% (302) 744-6156
2 RELIAS EMERGENCY MEDICINE SPECIALISTS OF TUPELO LLC TUPELO EMERGENCY MEDICINE 39 908 $1,496,384 $1,648 premium 6.8% 2.0% (662) 377-3000
3 RWJBH EMERGENCY MEDICINE ASSOCIATES, LLC ELIZABETH EMERGENCY MEDICINE 780 867 $954,567 $1,101 premium 6.5% 1.9% (908) 994-5422
4 ALTEON HEALTH ALABAMA, LLC TALLADEGA EMERGENCY MEDICINE 43 627 $729,201 $1,163 premium 4.7% 1.4% (240) 686-2300
5 SUSSEX EMERGENCY ASSOCIATES LLC LEWES EMERGENCY MEDICINE 7 605 $781,660 $1,292 premium 4.5% 1.3% (302) 645-3289
6 EAST CENTRAL IOWA ACUTE CARE PLLC CEDAR RAPIDS EMERGENCY MEDICINE 6 438 $413,034 $943 premium 3.3% 1.0% (319) 369-7211
7 TEXAS PHYSICIAN RESOURCES, LLP DALLAS EMERGENCY MEDICINE 93 390 $614,997 $1,577 premium 2.9% 0.9% (214) 947-8181
8 CHRISTIANA CARE EMERGENCY PHYSICIANS LLC ELKTON EMERGENCY MEDICINE 67 339 $407,105 $1,201 premium 2.5% 0.7% (410) 398-4000
9 WAKE FOREST EMERGENCY PROVIDERS CONCORD EMERGENCY MEDICINE 471 323 $362,624 $1,123 premium 2.4% 0.7% (704) 403-3000
10 EMERGENCY COVERAGE LLC RICHMOND EMERGENCY MEDICINE 755 260 $411,187 $1,581 premium 1.9% 0.6% (804) 289-4500
11 MAIN LINE EMERGENCY MED ASSOCIATES LLC PAOLI EMERGENCY MEDICINE 48 221 $177,236 $802 premium 1.6% 0.5% (484) 337-3583
12 EMERGENCY ASSOCIATES - UNIVERSITY OF ROCHESTER ROCHESTER EMERGENCY MEDICINE 60 205 $152,358 $743 premium 1.5% 0.4% (585) 275-9555
13 EMERGENCY PHYSICIANS INC FLEMING ISLAND EMERGENCY MEDICINE 100 171 $271,360 $1,587 premium 1.3% 0.4% (904) 516-1000
14 NEWARK EMERGENCY CENTER NEWARK EMERGENCY MEDICINE 27 120 $113,160 $943 premium 0.9% 0.3% (302) 738-4300
15 DOYLESTOWN EMERGENCY ASSOCIATES PC DOYLESTOWN EMERGENCY MEDICINE 3 114 $175,104 $1,536 premium 0.9% 0.2% (215) 345-2652
16 FLORIDA EMERGENCY PHYSICIANS KANG AND ASSOCIATES MD LLC ORLANDO EMERGENCY MEDICINE 310 107 $195,223 $1,825 premium 0.8% 0.2% (407) 303-5600
17 YORK HOSPITAL YORK EMERGENCY MEDICINE 90 101 $38,936 $386 premium 0.8% 0.2% (717) 851-2345
18 CEP AMERICA LLC DECATUR EMERGENCY MEDICINE 960 82 $127,618 $1,556 premium 0.6% 0.2% (510) 851-7493
19 EVERGREEN EMERGENCY SERVICES PS KIRKLAND EMERGENCY MEDICINE 47 73 $119,209 $1,633 premium 0.5% 0.2% (425) 899-1000
20 EMERGENCY PHYSICIANS PROFESSIONAL ASSOCIATION BLOOMINGTON EMERGENCY MEDICINE 268 70 $71,680 $1,024 premium 0.5% 0.2% (952) 835-9880
21 HADDON EMERGENCY PHYSICIANS LLC CAMDEN EMERGENCY MEDICINE 21 41 $75,848 $1,850 premium 0.3% 0.1% (954) 939-5000

*"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 →