NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
99425 Principal care management services for a single high-risk disease, each additional 30 minutes provided personally by qualified health care professional, per calendar month CPT · E&M
Classification E&M Care Management/Coordination Chronic, Principal, and Transitional Care Management (CMS RBCS)
First observed 2022
National scale 11,788 services ▲ 7.1% YoY · 3,788 beneficiaries (CY2024, Medicare FFS)
Medicare paid $544K · $46.11 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups
27
Named-group FFS services
6,359
FFS of Medicare
49%
Services YoY
+7.1%
FFS enrollment -2.2%
Estimated all-Medicare volume FFS + estimated MA estimate
~11,720 services

6,359 observed fee-for-service (54%) · ~5,361 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

Top states — 99425 (CY2024)

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

Named-group submitted charges
$622K
Named-group allowed amount
$378K
Named-group Medicare payments
$300K
Avg charge / svc
$98
Avg allowed / svc
$60
Avg payment / svc
$47
Average charge per group
$58 27 groups · avg submitted charge / service $485
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Data year: CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Physician groups ranked by 99425 services, highest first, CY2024
# Physician group activate to sort City activate to sort St activate to sort Specialty activate to sort Providers activate to sort 99425 svcs sorted descending — activate to reverse Submitted charges activate to sort Avg charge activate to sort Medicare $ locked column Share* activate to sort Phone
1 ADVANCED WELLNESS MARLBORO NJ CHIROPRACTIC 16 1,556 $108,920 $70 premium 63.3% (732) 431-2155
2 FREEDMAN RPM MEDICAL SC SKOKIE IL FAMILY PRACTICE 2 1,189 $118,900 $100 premium 76.3% (847) 443-1170
3 SUMMIT MEDICAL ARTS ASSOCIATES LLC NORTH BERGEN NJ INTERNAL MEDICINE 2 904 $100,906 $112 premium 36.7% (201) 453-2800
4 MOUNTAIN VIEW HEADACHE AND SPINE INSTITUTE PLLC PHOENIX AZ NURSE PRACTITIONER 8 488 $59,640 $122 premium 81.9% (602) 767-0007
5 HEARTFUL CARDIOLOGY, PLLC MANSFIELD TX NURSE PRACTITIONER 3 471 $28,282 $60 premium 24.6% (817) 752-5242
6 DAVENPORT MEDICAL INC OAK PARK IL INTERNAL MEDICINE 2 357 $28,560 $80 premium 22.9% (773) 543-8964
7 INFINITE MEDICAL PC LAKELAND NY NURSE PRACTITIONER 87 230 $26,450 $115 premium 48.3% (212) 734-6621
8 GULFSIDE BEHAVIORAL CARE NP INC BRADENTON FL NURSE PRACTITIONER 3 194 $11,310 $58 premium 56.4% 9417561200103
9 COMMUNITY ORTHOPEDIC MEDICAL GROUP MISSION VIEJO CA PHYSICIAN ASSISTANT 16 127 $17,145 $135 premium 28.7% (949) 348-4000
10 CARDIO AND RENAL THERAPEUTICS OF NORTH TEXAS PLLC MCKINNEY TX NURSE PRACTITIONER 34 108 $8,640 $80 premium 5.6% (214) 272-2774
11 WAKEMED SPECIALISTS GROUP LLC RALEIGH NC PHYSICIAN ASSISTANT 860 97 $16,810 $173 premium 8.0% (919) 350-7270
12 DERMATOLOGY HOUSE CALLS LLC ANDERSON SC NURSE PRACTITIONER 2 93 $6,008 $65 premium 100.0% (864) 365-6405
13 JAMES PETROS MD INC SAN JOSE CA PHYSICAL MEDICINE AND REHABILITATION 20 74 $35,863 $485 premium 16.7% (408) 528-8833
14 CAPITAL CARDIOLOGY ASSOCIATES PLLC ALBANY NY NURSE PRACTITIONER 68 62 $6,820 $110 premium 13.0% (518) 292-6000
15 INFINITE MEDICAL PC LAKELAND PA NURSE PRACTITIONER 87 51 $5,865 $115 premium 100.0% (212) 734-6621
16 RAJIV SIDDARAMU MD PLLC SCOTTSDALE AZ NURSE PRACTITIONER 9 41 $4,100 $100 premium 6.9% (602) 753-8120
17 UROLOGY SPECIALISTS CHARTERED SIOUX FALLS SD DIAGNOSTIC RADIOLOGY 45 35 $3,850 $110 premium 100.0% (605) 336-0635
18 FREDERICKSBURG NEPHROLOGY ASSOCIATES INC FREDERICKSBURG VA NEPHROLOGY 11 31 $2,967 $96 premium 100.0% (540) 371-3010
19 HARBOR YOUTH AND FAMILY COUNSELING TUKWILA WA NURSE PRACTITIONER 29 30 $3,300 $110 premium 100.0% 70279035833583
20 TEXAS SPECIALIST CENTER PLLC LUFKIN TX ORTHOPEDIC SURGERY 9 29 $3,480 $120 premium 1.5% (936) 634-8800
21 CORA HEALTH SERVICES INC THE VILLAGES FL ORTHOPEDIC SURGERY 1187 28 $3,500 $125 premium 8.1% (352) 693-3378
22 CSH CORP. DALLAS TX NURSE PRACTITIONER 14 24 $4,800 $200 premium 1.3% (972) 798-8001
23 BRONX MEDICAL PRACTICE PC BRONX NY NURSE PRACTITIONER 135 23 $2,070 $90 premium 4.8% (718) 299-7295
24 INFINITE MEDICAL PC LAKELAND FL NURSE PRACTITIONER 87 23 $2,645 $115 premium 6.7% (212) 734-6621
25 INFINITE MEDICAL PC LAKELAND RI NURSE PRACTITIONER 87 20 $2,300 $115 premium 100.0% (212) 734-6621
26 CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION LLC SUN CITY AZ PHYSICIAN ASSISTANT 254 17 $2,428 $143 premium 2.9% (866) 974-2673
27 WILLIAM NOYES MD PC GRAND FORKS ND MEDICAL ONCOLOGY 4 15 $1,770 $118 premium 100.0% (701) 787-5800
28 POST ACUTE SPECIALISTS OF TEXAS PA AUSTIN TX NURSE PRACTITIONER 25 15 $1,725 $115 premium 0.8% (866) 473-0663
29 BEAUMONT BONE AND JOINT INSTITUTE PA BEAUMONT TX ORTHOPEDIC SURGERY 19 14 $1,428 $102 premium 0.7% (409) 838-0346
30 RHEUMATIC DISEASE CENTER PHYSICIANS SC DES PLAINES IL RHEUMATOLOGY 4 13 $1,040 $80 premium 0.8% (847) 800-0998

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. 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 →