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Market snapshot

99309 nationwide CY2024

Medicare Part B FFS · CY2024 · 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
5,138
Named-group FFS services
7,013,241
FFS of Medicare
49%
Services YoY
+19.9%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~14,133,486 services

7,013,241 observed fee-for-service (50%) · ~7,120,245 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; 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
$1.5B
Named-group allowed amount
$677.6M
Named-group Medicare payments
$524.7M
Avg charge / svc
$209
Avg allowed / svc
$97
Avg payment / svc
$75
Average charge per group
$60 5,138 groups · avg submitted charge / service $1,378
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Specialty market — Hospice/Palliative Care: 800 services — specialty benchmark suppressed (fewer than 11 groups) — showing state benchmark. See Hospice/Palliative Care across all states →

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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by 99309 services, CY2024
#Physician group City St Specialty Providers 99309 svcs Submitted charges Avg charge Medicare $ locked column Share of specialty*Share of state* Phone
1 HARGRODER MEDICAL, INC. EUNICE LA HOSPICE/PALLIATIVE CARE 2 800 $160,000 $200 premium 0.4% (337) 684-5232

*"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 →