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Market snapshot

99291 in PA CY2024

Medicare Part B FFS · CY2024 · as published by CMS

99291 — Critical care, first 30-74 minutes

Billing groups
467
Named-group FFS services
179,925
FFS of Medicare
46%
Services YoY
+1.2%
FFS enrollment -2.5%
Estimated all-Medicare volume FFS + estimated MA estimate
~382,057 services

179,925 observed fee-for-service (47%) · ~202,132 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
$151.8M
Named-group allowed amount
$37.1M
Named-group Medicare payments
$29.3M
Avg charge / svc
$844
Avg allowed / svc
$206
Avg payment / svc
$163
Average charge per group
$222 467 groups · avg submitted charge / service $4,453
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Specialty market — Pulmonary Disease: 11,221 services across 13 groups; top group 36%. See Pulmonary Disease across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 99291 services, CY2024
#Physician group City Specialty Providers 99291 svcs Submitted charges Avg charge Medicare $ locked column Share of specialty*Share of state* Phone
1 PULMONOLOGY ASSOCIATES INC PAOLI PULMONARY DISEASE 18 4,037 $1,312,025 $325 premium 36.0% 1.5% (610) 648-0553
2 TEXAS IPS LLC SAN ANTONIO PULMONARY DISEASE 42 3,242 $2,165,656 $668 premium 28.9% 1.2% (210) 690-7400
3 RESPIRATORY SPECIALISTS LTD WYOMISSING PULMONARY DISEASE 19 1,346 $554,552 $412 premium 12.0% 0.5% (610) 685-5864
4 BUCKS COUNTY MEDICAL ASSOCIATES, P.C. DOYLESTOWN PULMONARY DISEASE 10 1,044 $455,070 $436 premium 9.3% 0.4% (215) 348-1310
5 PULMONARY CRITICAL CARE AND SLEEP PHYSICIANS OF THE MAIN LINE PC MEDIA PULMONARY DISEASE 7 490 $171,500 $350 premium 4.4% 0.2% (484) 442-8235
6 GBR, LLC LAFAYETTE PULMONARY DISEASE 14 318 $147,552 $464 premium 2.8% 0.1% (337) 234-3204
7 LAYOUS LLC CROWN POINT PULMONARY DISEASE 4 246 $158,916 $646 premium 2.2% 0.1% (219) 595-5754
8 RESPIRATORY, CRITICAL CARE AND SLEEP SPECIALISTS, LLC DES PLAINES PULMONARY DISEASE 9 214 $140,501 $657 premium 1.9% 0.1% (847) 376-8969
9 LIFELINE CENTERS PC WASHINGTON PULMONARY DISEASE 4 93 $49,755 $535 premium 0.8% 0.0% (412) 351-6545
10 SHORE PULMONARY, PA BRICK PULMONARY DISEASE 18 86 $35,260 $410 premium 0.8% 0.0% (732) 775-9075
11 CHAUDHRY PULMONARY ASSOC PC MCKEESPORT PULMONARY DISEASE 2 53 $19,080 $360 premium 0.5% 0.0% (412) 672-9240
12 NATIONAL JEWISH HEALTH DENVER PULMONARY DISEASE 243 26 $15,953 $614 premium 0.2% 0.0% (303) 398-1355
13 PULMONARY MEDICAL CONSULTANTS INC DARBY PULMONARY DISEASE 2 26 $9,100 $350 premium 0.2% 0.0% (610) 534-6140

*"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 →