Family Medicine

Revenue intelligence for Family Medicine practices. See national E&M coding benchmarks, CCM/RPM/BHI adoption rates, and AWV completion data.

$95K

Avg Missed/Year

148K

US Providers

380

Avg Patients

2.8

Avg Chronic Dx

Specialty Overview

Family Medicine providers are the backbone of Medicare primary care, managing complex multi-condition patients across all age groups. Despite seeing the highest volume of Medicare patients eligible for care management programs, Family Medicine has some of the lowest adoption rates for CCM, RPM, and BHI — creating the largest untapped revenue opportunity in primary care.

Key Insight: A Family Medicine practice with 380 Medicare patients implementing CCM, RPM, and proper E&M coding can capture an additional $94,600+ per year — the equivalent of hiring another staff member.

E&M Coding Distribution

National benchmark for Family Medicine E&M code distribution. Compare your practice against these targets to identify coding optimization opportunities.

99213

30%

$92/visit

99214

50%

$130/visit

99215

20%

$176/visit

Revenue Gap Breakdown

#1

E&M Coding Gap

$26.4K/yr

35% of Family Medicine practices overuse 99213 when documentation supports 99214. The national benchmark shows optimal distribution at 30% 99213 / 50% 99214 / 20% 99215.

#2

CCM (99490)

$28.8K/yr

Only 12% of eligible patients are enrolled in CCM nationally. With 380 avg Medicare patients and 55%+ having 2+ chronic conditions, most practices have 100+ eligible patients generating zero CCM revenue.

#3

RPM (99453-99458)

$18.4K/yr

RPM adoption is only 6% among Family Medicine providers. Hypertension monitoring alone could cover 40%+ of the Medicare panel.

#4

AWV (G0438/G0439)

$14.2K/yr

AWV completion rate averages 35% nationally. With zero patient copay, proactive outreach can push completion above 70% — doubling AWV revenue.

#5

BHI (99484)

$6.8K/yr

Behavioral health integration is adopted by only 4% of Family Medicine practices despite 22% of Medicare patients screening positive for depression.

Care Management Adoption Rates

CCM

12%

Target: 15%

RPM

6%

Target: 10%

BHI

4%

Target: 10%

AWV

35%

Target: 70%

Common Chronic Conditions

Hypertension (58%)Diabetes (35%)Depression (22%)COPD (14%)Heart Failure (12%)

Family Medicine Provider? See Your Gaps

These are national averages. Scan your NPI to see how your billing compares to Family Medicine benchmarks and get a personalized revenue roadmap.

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