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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
99427 Principal care management services for a single high-risk disease, each additional 30 minutes of clinical staff time directed by 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 214,085 services · est. ▲ 65.0% YoY · 46,042 FFS beneficiaries (CY2024, all-Medicare estimate) — 107,285 observed fee-for-service services
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Data year CY2024 CY2023 CY2022 locked column CY2021 locked column CY2020 locked column
Market overview
Market Brief 99427
The whole of 99427, written up and sourced.

The Brief is a national document for 99427. Its findings page carries one finding per chapter, each opening the chapter that prints its figure and the table behind it — like these, from the United States, CY2024, the market on this page.

  1. 1Size and growth. The national market for 99427 ran ~214,085 all-Medicare services (estimated), 107,285 observed fee-for-service in CY2024. The market is up 65.0% year over year. 181 billing groups and 898 clinicians bill it.
  2. 2Payment. Half the field lists between $76 and $124 per service; the median group lists $98. Submitted charges are provider-set list amounts, not payments.
  3. 3Geography. FL, TX, NY and MD lead the state markets — together 40% of state-market volume.
Estimated all-Medicare volume estimate
FFS + estimated MA

~214,085 services

107,285 observed fee-for-service (50%) · ~106,800 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
Average charge
per service, submitted list amounts — not payments · named-group basis, observed FFS
Average payment
per service, Medicare paid amounts — not charges · all disclosed claims, observed FFS basis
Charge-to-payment ratio
average list price vs average Medicare payment per service · named-group basis
What they charge

Half the field lists between $76 and $124

Submitted charges are provider-set list amounts, not payments · median $98 (named groups)
Every group, one dot181 billing groups · median $98

The same field as one dot per billing group: where the cluster sits, and how far the tail reaches

$0$100$200++4 groups list more, to $286 →average submitted charge per service, per billing groupmedian $98
One dot per billing group, 99427 nationwide CY2024 — average submitted charge per service, provider-set list amounts, not payments. The axis caps near the 95th percentile so the cluster is legible; groups beyond it draw at the cap in accent and are counted on the chart.
Where the market isobserved FFS services by state · CY2024
ME: 43MEVTNHWA: 2248WAID: 416IDMTND: 68NDMN: 27MNWIIL: 6143ILMI: 1032MINY: 11679NYMA: 600MARI: 346RIOR: 367ORNV: 2318NVWY: 188WYSD: 14SDIA: 488IAIN: 617INOH: 1424OHPA: 1271PANJ: 2433NJCT: 33CTCA: 2902CAUT: 1227UTCO: 4181CONE: 189NEMO: 2770MOKY: 5597KYWVVA: 2198VAMD: 6652MDDE: 1420DEAZ: 5951AZNM: 1039NMKS: 19KSAR: 3706ARTN: 5498TNNC: 529NCSC: 864SCDC: 1373DCOK: 1682OKLA: 933LAMS: 303MSAL: 499ALGA: 1175GAHI: 220HIAK: 23AKTX: 11959TXFL: 12621FL
Shaded low→high on observed fee-for-service services billed from each state · the /stats tile grid, at national scope. Shading ranks the states rather than spacing them along the range, so neighboring shades mean adjacent RANKS, not equal gaps — the key names the lowest and highest; each tile carries its own figure.
Which states movedservices per 1,000 FFS beneficiaries · CY2022 → CY2024
CY2022CY2024AL: 0 → 1AR: 1 → 11AZ: 0 → 9CA: 0 → 1CO: 0 → 10DE: 1 → 10HI: 0 → 2IL: 1 → 5KY: 0 → 14LA: 2 → 3MI: 0 → 1MN: 0 → 0MS: 2 → 1NC: 0 → 1NM: 0 → 5NV: 0 → 10OK: 2 → 4OR: 1 → 1SC: 6 → 1TN: 0 → 9UT: 2 → 7WY: 1 → 2FL: 0 → 7MD: 0 → 9NY: 1 → 8TX: 0 → 7NY 1TX 0MD 0FL 09 MD8 NY7 TX7 FL
One line per state market, 26 drawn; the 4 leading states by volume are in accent, the rest are context lines. Both columns share one scale, so a slope is real change. A RATE against each state’s own fee-for-service population — assumption-free, and no all-Medicare estimate is used or implied. CY2022 is the left period because CY2020 is the pandemic year and a slope off it would read as growth almost everywhere. 20 states with a rate in only one of the two years are not drawn.

Open a state market: FL · TX · NY · MD · IL · AZ · KY · TN · CO · AR · CA · MO — the group ranking lives in the Provider groups tab. Territories bill too; the tile grid draws the 50 states and DC.

Every group in this market, placed by list charge against volume

This market’s groups, on one chart181 groups · bubble = services
1001,000One billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing groupOne billing group$20$50$100$150$200+Average submitted charge per service — list amounts, not paymentsServices per group — 99427, CY2024
One mark per physician group, 99427 nationwide CY2024 — marks are unnamed here: a mark’s position is its average list charge, and that figure is part of the platform. Submitted charges are provider-set list amounts, not payments.

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