- Market size ~6,328 all-Medicare services · est. (3,186 observed FFS).
- Who bills it 43 billing groups and 114 clinicians bill 99446 nationally (at the ≥11-service disclosure floor).
- Growth Down 24.5% year over year; -42.9% over five years (2020 → 2024). The five-year base year, 2020, is the pandemic year.
- Market structure The top five groups hold 41.2% of attributed national volume.
- Medicare paymentMedicare's payments for 99446 nationally in 2024, and the payment per service. Notify me at launch →
- Leading markets CA, MS, TX and NC lead the state markets — together 59% of state-market volume.
The Brief is a national document for 99446. 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.
- 1Size and growth. The national market for 99446 ran ~6,328 all-Medicare services (estimated), 3,186 observed fee-for-service in CY2024. The market is down 24.5% year over year. 43 billing groups and 114 clinicians bill it.
- 2Payment. Half the field lists between $44 and $113 per service; the median group lists $56. Submitted charges are provider-set list amounts, not payments.
- 3Geography. CA, MS, TX and NC lead the state markets — together 59% of state-market volume.
~6,328 services
3,186 observed fee-for-service (50%) · ~3,142 estimated Medicare Advantage.
Half the field lists between $44 and $113
The same field as one dot per billing group: where the cluster sits, and how far the tail reaches
Open a state market: CA · MS · TX · NC · MA · MD · WI · NY · OH · CO · LA · NJ — 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
Physician groups ranked by 99446 services, highest first, CY2024. Every sort re-runs the search across the whole market — these are the market's true top rows on this measure, never a re-order of this page.
Showing the top 25 of 43 groups — the full ranking is part of the Platform. Explore the Platform →
Medicare $ counts 99446 payments nationwide, CY2024; avg list is that row's submitted charges per service on the same basis — list amounts, not payments. Each national row sums the group's volume across the state markets it bills in — state-level shares are per-market figures and are not shown at this scope. See Methods.
*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 — and the observed foundation every market figure here builds on. Market totals anchor on a labeled all-Medicare estimate scaled from that foundation, with the observed count disclosed beside it — Medicare only, never all-payer. Modeled all-payer databases project every payer statistically and typically run higher. Same market, different denominator. How the numbers reconcile →
114 clinicians billed 99446 nationally in CY2024 — 3,168 observed fee-for-service services. Individual clinicians only; organizational billers are listed under Provider groups.
Clinicians ranked by 99446 services, highest first, CY2024. Every sort re-runs the search across the whole market.
Showing the top 25 of 114 clinicians — the full clinician ranking is part of the Platform. Explore the Platform →
Services and patients are observed Medicare fee-for-service counts for 99446 billed by each clinician nationwide, CY2024; avg list is submitted charges per service — list amounts, not payments. Clinician×code rows under 11 beneficiaries are suppressed by CMS, so small billers are absent by construction. See Methods.