Pulmonology
Revenue benchmarks for Pulmonology practices. COPD management programs, RPM opportunities, and E&M coding optimization data.
$128K
Avg Missed/Year
12K
US Providers
380
Avg Patients
3.5
Avg Chronic Dx
Specialty Overview
Pulmonology practices manage high-complexity respiratory patients with significant care management needs. COPD, the hallmark condition, requires ongoing monitoring and care coordination that aligns perfectly with CCM and RPM billing. Pulse oximetry RPM for COPD patients is one of the highest-ROI programs available.
Key Insight: Pulse oximetry RPM for COPD patients is one of the highest-margin programs in healthcare — requiring minimal staff time while generating $120+/month per enrolled patient.
E&M Coding Distribution
National benchmark for Pulmonology E&M code distribution. Compare your practice against these targets to identify coding optimization opportunities.
99213
22%
$92/visit
99214
50%
$130/visit
99215
28%
$176/visit
Revenue Gap Breakdown
E&M Coding Gap
Complex respiratory patients justify high-level MDM. Benchmark: 22% 99213 / 50% 99214 / 28% 99215.
CCM (99490)
16% adoption with 45% COPD prevalence. Most pulmonology patients have multiple qualifying conditions.
RPM (99453-99458)
Pulse oximetry monitoring for COPD patients is clinically effective and generates $120+/month per patient. Only 10% adoption.
AWV (G0438/G0439)
18% AWV rate — these patients should be screened for all preventive services.
BHI (99484)
COPD and depression are strongly comorbid. Screening and BHI enrollment can address both clinical and financial gaps.
Care Management Adoption Rates
CCM
16%
Target: 15%
RPM
10%
Target: 10%
BHI
4%
Target: 10%
AWV
18%
Target: 70%
Common Chronic Conditions
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Pulmonology Provider? See Your Gaps
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