NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
G0443 Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes HCPCS · E&M
Classification E&M › Behavioral Health Services (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 1,281 services ▲ 43.1% YoY · 1,075 beneficiaries (CY2024, Medicare FFS)
Medicare paid $31K · $23.95 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

15

Named groups billing this code
Named-group all-Medicare svcs · est.

755

Scaled from 391 observed FFS services.
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

+38.9%

All-Medicare est. · observed FFS +43.1%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~755 services

391 observed fee-for-service (52%) · ~364 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 — G0443 (CY2024)
FL 421 CA 210 NJ 166 AL 123 SC 56

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
$22K
Named-group allowed amount
$10K
Named-group Medicare payments
$10K
Avg charge / svc
$57
Avg allowed / svc
$25
Avg payment / svc
$25
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
$26 15 groups · avg submitted charge / service $100
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers G0443 svcs Submitted charges Avg charge Medicare $ Share of state* Phone
1 ANIL GEORGE MD PA JACKSONVILLE FL FAMILY PRACTICE 4 60 $1,560 $26 14.3% (904) 353-8562
2 USHA CONSULTING LLC LITTLE RIVER SC FAMILY PRACTICE 2 56 $2,632 $47 100.0% (843) 492-5009
3 BON SECOURS MEDICAL GROUP RICHMOND PRIMARY CARE LLC TAPPAHANNOCK VA FAMILY PRACTICE 97 45 $3,420 $76 100.0% (804) 443-5378
4 INTERNAL MEDICINE AND GERIATRICS PRACTICE, INC CLIFTON NJ NURSE PRACTITIONER 5 27 $2,345 $87 16.3% (973) 253-6000
5 EXCELCARE MEDICAL ASSOCIATES PA TEANECK NJ NURSE PRACTITIONER 199 26 $2,340 $90 15.7% (201) 836-7970
That's the top 5 of 15 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 →