California
Medicare Revenue Gap Analysis
98.4K
Medicare Providers
6.4M
Beneficiaries
$104.2K
Avg Missed/Provider
$10253.3M
Total State Gap
Revenue Gap Breakdown
E&M Coding Gap
$28.6K/yr
Average undercoding gap from 99213→99214 shifts
CCM Revenue Gap
$33.3K/yr
11% adoption rate — national benchmark: 15%
RPM Revenue Gap
$22.9K/yr
7% adoption rate — national benchmark: 8%
AWV Revenue Gap
$14.6K/yr
48% completion rate — target: 70%+
BHI Revenue Gap
$8.3K/yr
Behavioral health integration opportunity
Top Cities in California
#1
Los Angeles
22,400 providers
Est. gap: $1984.0M
#2
San Francisco
8,640 providers
Est. gap: $765.2M
#3
San Diego
7,820 providers
Est. gap: $692.6M
#4
San Jose
5,240 providers
Est. gap: $464.1M
#5
Sacramento
4,680 providers
Est. gap: $414.5M
Care Management Adoption
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