Medicare Revenue Report Card 2026
Pennsylvania
58K Medicare providers analyzed
One-Click LinkedIn Post
I just reviewed the 2026 Medicare Revenue Report Card for Pennsylvania. Key findings: - Overall Grade: F - Estimated Missed Revenue: $90K - Low adoption of care management programs (CCM, RPM, BHI, AWV) The data comes directly from CMS public records — every medical practice can see exactly how much revenue they're leaving on the table. See the full Pennsylvania report card:
https://npixray.com/reports/states/pennsylvania
Total Providers
58K
in Pennsylvania
Total Medicare Payment
$3755.6M
Avg Payment / Provider
$65K
Est. Missed Revenue
$90K
across all providers
Care Management Program Adoption
How Pennsylvania providers compare to the national average in adopting revenue-generating care management programs.
CCM
Chronic Care Management
$62/patient/mo potential revenue
RPM
Remote Patient Monitoring
$120/patient/mo potential revenue
BHI
Behavioral Health Integration
$50/patient/mo potential revenue
AWV
Annual Wellness Visits
$175/visit potential revenue
Pennsylvania Trend Signals
Revenue per Provider
$64,680
-18.9% vs benchmark · national avg $79,744
Provider Market Share
4.9% of US
+100.0% vs benchmark · 58,065 providers
CCM Adoption
0.0%
-100.0% vs benchmark · national 2.4%
RPM Adoption
0.0%
-100.0% vs benchmark · national 1.1%
AWV Completion
0.0%
-100.0% vs benchmark · national 7.8%
E&M Coding Distribution
How Pennsylvania providers distribute evaluation and management visits compared to the national benchmark. Higher 99214/99215 rates indicate thorough documentation and appropriate complexity coding.
99213
Level 3
33.0%
National: 31.2%
99214
Level 4
34.0%
National: 56.4%
99215
Level 5
33.0%
National: 9.3%
Top Specialties in Pennsylvania
| Specialty | Providers | Avg Payment |
|---|---|---|
| Nurse Practitioner | 6,828 | $23K |
| Physician Assistant | 5,960 | $18K |
| Internal Medicine | 4,217 | $59K |
| Family Practice | 4,069 | $52K |
| Physical Therapist in Private Practice | 2,953 | $50K |
| Emergency Medicine | 2,594 | $39K |
| Certified Registered Nurse Anesthetist (CRNA) | 2,500 | $8K |
| Chiropractic | 1,663 | $13K |
| Anesthesiology | 1,656 | $22K |
| Mass Immunizer Roster Biller | 1,582 | $54K |
| Diagnostic Radiology | 1,548 | $85K |
| Optometry | 1,439 | $29K |
| Hospitalist | 1,119 | $53K |
| Cardiology | 1,045 | $129K |
| Psychiatry | 1,003 | $28K |
| General Surgery | 991 | $31K |
| Podiatry | 951 | $82K |
| Orthopedic Surgery | 937 | $101K |
| Obstetrics & Gynecology | 928 | $15K |
| Ophthalmology | 799 | $445K |
City Report Cards in Pennsylvania
Philadelphia
Pittsburgh
Allentown
Bethlehem
York
Lancaster
Erie
Hershey
Danville
Harrisburg
Scranton
Wilkes Barre
West Chester
Altoona
State College
Chambersburg
Williamsport
Wynnewood
Bryn Mawr
Abington
Top 20 Providers in Pennsylvania
Highest-volume Medicare providers by total payment.
| Provider | Patients | Medicare $ |
|---|---|---|
| Cernostics, Inc. | 4,850 | $44.5M |
| Silverpath, Inc. | 40,424 | $41.9M |
| Accredo Health Group Inc | 76 | $37.8M |
| Interpace Diagnostics Corporation | 2,798 | $15.5M |
| Sma Medical, Inc. | 16,604 | $13.4M |
| Unity Holding Groups Llc | 2,407 | $13.0M |
| Health Network Laboratories, Llc | 49,962 | $12.5M |
| Medarbor Llc | 9,812 | $12.3M |
| Quest Diagnostics Of Pennsylvania, Inc. | 60,616 | $11.3M |
| Cardionet, Llc | 33,973 | $11.0M |
| Skippack Medical Lab, Llc | 29,972 | $10.6M |
| Brookside Clinical Laboratory Inc | 4,985 | $10.6M |
| Procare Pharmacy Direct, Llc. | 14 | $8.3M |
| Institute For Dermatopathology, Inc. | 66,230 | $8.3M |
| City Of Philadelphia | 12,148 | $8.3M |
| Nehal GandhiMD | 691 | $8.0M |
| Center For Emergency Medicine Of Western Pennsylvania | 1,522 | $7.9M |
| Freedom Pathology Partners Llc | 4,835 | $7.4M |
| Quest Diagnostics Venture Llc | 32,211 | $7.2M |
| Omesh GuptaMD | 1,988 | $7.1M |
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