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Market snapshot

99309 nationwide CY2023

Medicare Part B FFS · CY2023 · as published by CMS

99309 — Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes

Billing groups
5,261
Named-group FFS services
5,792,080
FFS of Medicare
49%
Services YoY
+19.9%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~11,237,898 services

5,792,080 observed fee-for-service (52%) · ~5,445,818 estimated Medicare Advantage. Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2023) — scaled estimate — assumes MA utilization mirrors FFS; not an observation; 3 states without payer-mix data excluded. How we scale

Top states — 99309 (CY2024)

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

Named-group submitted charges
$1.2B
Named-group allowed amount
$563.7M
Named-group Medicare payments
$436.3M
Avg charge / svc
$201
Avg allowed / svc
$97
Avg payment / svc
$75
Average charge per group
$60 5,261 groups · avg submitted charge / service $900
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Specialty market — Geriatric Medicine: 18,416 services across 18 groups; top group 23%. See Geriatric Medicine across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 99309 services, CY2023
#Physician group City St Specialty Providers 99309 svcs Submitted charges Avg charge Medicare $ locked column Share of specialty*Share of state* Phone
1 ASPEN MEDICAL ASSOCIATES, PA TEANECK NJ GERIATRIC MEDICINE 3 4,195 $469,018 $112 premium 0.7% (201) 928-0200
2 LIMA GERONTOLOGY ASSOCIATES LLP GLEN RIDDLE-LIMA PA GERIATRIC MEDICINE 2 2,414 $325,890 $135 premium 0.4% (610) 891-5840
3 ALLIANCE POST ACUTE ASSOCIATES LLC RICHARDSON TX GERIATRIC MEDICINE 2 2,356 $567,274 $241 premium 0.3% (214) 797-6149
4 GEROMED LLC ST LOUIS MO GERIATRIC MEDICINE 2 2,341 $316,035 $135 premium 1.1% (314) 752-8600
5 MEDSTAR TOTAL ELDER CARE, LLC WASHINGTON MD GERIATRIC MEDICINE 25 2,045 $609,954 $298 premium 0.4% (202) 877-0570
6 TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND UTICA NY GERIATRIC MEDICINE 4 917 $95,267 $104 premium 0.1% (315) 798-4811
7 MEDASSIST NJ II SPRING VALLEY PA GERIATRIC MEDICINE 23 827 $267,121 $323 premium 0.1% (845) 377-6670
8 GRACE GERIATRIC CARE INC GARDEN GROVE CA GERIATRIC MEDICINE 2 554 $157,890 $285 premium 0.1% (657) 208-2221
9 CENTRAL JERSEY MEDICINE AND GERIATRICS, LLC PRINCETON NJ GERIATRIC MEDICINE 3 544 $81,625 $150 premium 0.1% (609) 921-8766
10 GERIATRIC HEALTH AND WELLNESS LTD CO. WEST COLUMBIA SC GERIATRIC MEDICINE 3 447 $79,119 $177 premium 0.2% (803) 788-5916
11 HUNTINGTON GERIATRIC MEDICAL GROUP PASADENA CA GERIATRIC MEDICINE 3 385 $49,850 $129 premium 0.0% (626) 229-9865
12 GIO PLLC TULSA OK GERIATRIC MEDICINE 2 356 $45,795 $129 premium 0.2% (918) 528-4189
13 HEELEX 2 LLC SURPRISE AZ GERIATRIC MEDICINE 3 318 $57,545 $181 premium 0.2% (623) 270-7441
14 YDR GERIATRICS AND NEPHROLOGY, LLP BRONX NY GERIATRIC MEDICINE 4 239 $33,392 $140 premium 0.0% (718) 690-3666
15 GERIATRIC MEDICAL ASSOCIATES OF NEVADA LLC LAS VEGAS NV GERIATRIC MEDICINE 2 147 $27,195 $185 premium 0.1% (702) 960-4312
16 CAROLINA MEADOWS INC CHAPEL HILL PA GERIATRIC MEDICINE 8 123 $13,530 $110 premium 0.0% (919) 370-7299
17 CAROLINA MEADOWS INC CHAPEL HILL VA GERIATRIC MEDICINE 8 78 $8,580 $110 premium 0.0% (919) 370-7299
18 CAROLINA MEADOWS INC CHAPEL HILL OR GERIATRIC MEDICINE 8 76 $8,360 $110 premium 0.3% (919) 370-7299
19 MID ATLANTIC GERIATRIC ASSOCIATION OCEAN NJ GERIATRIC MEDICINE 2 34 $6,630 $195 premium 0.0% (732) 663-0099
20 THE CEDARS OF CHAPEL HILL CLUB INC CHAPEL HILL NC GERIATRIC MEDICINE 4 20 $2,782 $139 premium 0.0% (919) 259-7934

*"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 →