OB/GYN

OB/GYN is one of the most active Medicare specialties in the United States, with 18K providers billing Medicare nationally. The average OB/GYN provider treats 59 Medicare beneficiaries and receives $15K in total annual Medicare payments, yielding $262 per beneficiary on average.

Evaluation and Management coding patterns reveal how OB/GYN providers characterize visit complexity. The most frequently billed code is 99213 at 56.3%, suggesting a large share of straightforward follow-up visits. Only 39.1% of encounters are coded as 99214, and 4.6% as 99215 — which may indicate under-coding if the patient population carries significant chronic disease burden.

Care management program adoption presents a significant revenue opportunity for OB/GYN practices. Chronic Care Management (0.1%), Remote Patient Monitoring (0.0%), Behavioral Health Integration (0.0%) remain substantially underutilized relative to the eligible patient population. Annual Wellness Visit adoption sits at just 1.8%, well below the 70% target — meaning a majority of eligible Medicare beneficiaries are not receiving this preventive service, and practices are missing a straightforward billing opportunity. Providers who implement these programs can unlock substantial per-patient monthly revenue while improving chronic disease outcomes — NPIxray can help identify exactly which patients qualify.