NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
G0427 Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth HCPCS · E&M
Classification E&M › Emergency Department Services › Emergency Department E&M (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 26,350 services ▲ 19.8% YoY · 25,775 beneficiaries (CY2024, Medicare FFS)
Medicare paid $3.7M · $139.47 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

90

Named groups billing this code
Named-group FFS services

9,241

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+19.8%

FFS enrollment -2.2%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~19,313 services

9,241 observed fee-for-service (48%) · ~10,072 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 — G0427 (CY2024)
TX 3,828 FL 1,848 OH 1,588 TN 1,362 CA 1,289

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

Billed → allowed → paid
Named-group submitted charges
$5.0M
Named-group allowed amount
$1.6M
Named-group Medicare payments
$1.3M
Avg charge / svc
$542
Avg allowed / svc
$177
Avg payment / svc
$140
Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.
Average charge per group
$176 90 groups · avg submitted charge / service $1,641
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers G0427 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 ACCESS TELECARE PLLC SPRING TX NEUROLOGY 399 842 $432,430 $514 22.0% (972) 449-0540
2 ACCESS TELECARE PLLC SPRING IL NEUROLOGY 399 558 $286,784 $514 47.3% (972) 449-0540
3 ACCESS TELECARE PLLC SPRING GA NEUROLOGY 399 502 $257,701 $513 47.8% (972) 449-0540
4 OSU NEUROSCIENCE CENTER, LLC COLUMBUS OH NEUROLOGY 119 405 $299,700 $740 25.5% (614) 293-4969
5 MAHEEP SINGH BIRDI MD VISALIA OR NEUROLOGY 3 390 $200,440 $514 50.2% (661) 432-7851
That's the top 5 of 90 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*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 →