Table 1.

Payment Amounts, Eligibility, Current Use of Code, and Receipt of Service as Input Data Used for Revenue Estimates^*

Code	Medicare Payment in 2020 for Code, $ †	Service Eligibility (Eligible for Code, Percentage of Medicare Beneficiaries), %	Among Medicare Beneficiaries Eligible for Service/Code
			Billing Rate (Current Use of Billing Code, Percentage of Eligible), %	Service Provision (Received Service Regardless of Billing for Service, Percentage of Eligible), %‡
Prevention codes
Smoking cessation counseling	15.52–29.59	8.8	10.1	60.6
Alcohol misuse screening	18.41	100	2.9	57.4
Alcohol misuse counseling	26.71	16.0	<1	25.9
Depression screening	18.41	100	7.9	27.1
Behavioral counseling for cardiovascular disease	26.71	74.0	1.4	46.7
Obesity counseling	26.71	34.6	<1	51.9
Shared decision making for lung cancer screening	29.95	9.3	1.5	5.0
Advance care planning	76.15–86.98	100	3.7	22
Wellness visit	117.29–172.87	100	35.8	–
Coordination codes
Transitional care management	187.67–247.94	22.5	9.3	43.3
Chronic care management	37.89–92.39	65.8	2.3	–
Behavioral health integration	48.00–156.99	30.2	<1	–
Cognitive assessment with care planning services	265.26	10.5	1.5	–

^*See Supplement Methods and Supplement Table 4 (available at Annals.org) for further details and sources.

^†For some categories of prevention and coordination services, the full range of payment amounts are shown if there are multiple codes representing initial versus subsequent service delivery, different time requirements, or complexity. See Supplement Table 4 for an itemized list of payment codes.

^‡There is no estimate available for receipt of some services. In particular, the codes for wellness visits, chronic care management, behavioral health integration, and cognitive assessment with care planning services require a suite of services that are not routinely provided.