Medicare procedure market data by CPT code & state

Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS

G0323 Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following requi HCPCS · E&M

Classification E&M › Behavioral Health Services (CMS RBCS)

First observed 2023

National scale 6,534 services ▲ 124.8% YoY · 2,888 beneficiaries (CY2024, Medicare FFS)

Medicare paid $220K · $33.73 avg / service, national

CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window

Billing groups

Named-group FFS services

4,541

FFS of Medicare

49%

Services YoY

+124.8%

FFS enrollment -2.2%

Estimated all-Medicare volume FFS + estimated MA estimate

~9,526 services

4,541 observed fee-for-service (48%) · ~4,985 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 — G0323 (CY2024)

TX 1,749 NV 1,327 GA 891 IN 804 LA 465

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

Named-group submitted charges

$405K

Named-group allowed amount

$184K

Named-group Medicare payments

$143K

Avg charge / svc

$89

Avg allowed / svc

$41

Avg payment / svc

$32

Average charge per group

$52–63

$63–74

$74–85

$85–97

$97–108

$108–119

$119–130

$130+

$52 12 groups · avg submitted charge / service $150

Market analyticsPlatform

a taste of the twelve-year trend layer

Market position — where this market sits on volume and growth among all state markets, and its rank.
Worth a look — every state market for this search, ranked by a published score: size, growth, fragmentation, below-expected volume.
Lookalike opportunities — groups billing below what peers of the same specialty, size, and state predict, with the expected figure shown.
National benchmarks — where each group's volume sits nationally and within its specialty.
Market structure — how concentrated this market is, and who owns the volume.
Medicare-wide scaling — the payer split, and this market total scaled to all of Medicare, labeled as an estimate.

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Data year: CY2024 CY2023 CY2022 CY2021 CY2020

Physician groups ranked by G0323 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	G0323 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	TRAVIS J PTACEK MD PLLC	RAPID CITY	TX	FAMILY PRACTICE	11	1,014	$81,120	$80	premium	58.0%	(317) 370-2013
2	EMPOWERING HEALTHCARE SERVICES	DOUGLASVILLE	GA	NURSE PRACTITIONER	8	832	$124,900	$150	premium	93.4%	(404) 852-1333
3	MIDWEST POST ACUTE CARE PLLC	CHICAGO	IN	CLINICAL SOCIAL WORKER	111	781	$40,612	$52	premium	97.1%	(888) 705-8722
4	BRITTAIN AND ASSOCIATES INC	ORE CITY	TX	MENTAL HEALTH COUNSELOR	18	735	$39,591	$54	premium	42.0%	(903) 968-4641
5	OCHSNER AMERICAN LEGION HOSPITAL, LLC	JENNINGS	LA	NURSE PRACTITIONER	30	465	$62,347	$134	premium	100.0%	(337) 824-8868
6	MERIDIAN BEHAVIORAL HEALTHCARE INC	GAINESVILLE	FL	MENTAL HEALTH COUNSELOR	45	165	$15,675	$95	premium	48.5%	(352) 374-5600
7	ENDEAVOR HEALTH MEDICAL GROUP	EVANSTON	IL	NURSE PRACTITIONER	3380	151	$7,852	$52	premium	53.7%	—
8	LAHEY CLINIC INC	BURLINGTON	MA	NURSE PRACTITIONER	1400	101	$12,339	$122	premium	100.0%	—
9	HARBOR YOUTH AND FAMILY COUNSELING	TUKWILA	AZ	NURSE PRACTITIONER	29	81	$7,614	$94	premium	71.1%	70279035833583
10	COUNCIL FOR JEWISH ELDERLY	DEERFIELD	IL	CLINICAL SOCIAL WORKER	15	57	$2,964	$52	premium	20.3%	(847) 374-0500
11	MIDWEST POST ACUTE CARE PLLC	CHICAGO	IA	CLINICAL SOCIAL WORKER	111	53	$2,756	$52	premium	70.7%	(888) 705-8722
12	VITAE HEALTH MEDICAL ILLINOIS, PLLC	CHICAGO	IL	CLINICAL SOCIAL WORKER	202	40	$2,080	$52	premium	14.2%	—
13	HEALTH GROUP PROVIDERS LLC	TEMPE	AZ	NURSE PRACTITIONER	22	33	$3,102	$94	premium	28.9%	(602) 734-5664
14	MIDWEST POST ACUTE CARE PLLC	CHICAGO	IL	CLINICAL SOCIAL WORKER	111	33	$1,716	$52	premium	11.7%	(888) 705-8722

*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 →