Idaho Medicare Revenue Analysis

CMS Medicare Physician & Other Practitioners data

Idaho has 6K Medicare providers who collectively received $482.9M in Medicare payments, averaging $76K per provider. Idaho providers earn moderate Medicare revenue per provider, with significant opportunity to capture additional revenue through program enrollment and coding optimization.

The most common specialty is Nurse Practitioner with 994 providers, followed by Physician Assistant (944) and Family Practice (585). Nurse Practitioner providers in Idaho average $20K annually, with room to grow through CCM, RPM, and AWV program adoption.

The largest Medicare provider concentration is in Boise (1,695 providers), with Meridian and Coeur D Alene also serving as major healthcare hubs. Practices in these areas face competitive pressure, making revenue optimization through proper coding and program enrollment critical for financial performance.

Data: CMS Medicare Physician & Other Practitioners, 2024Coverage: 6,331 providers analyzedLast updated: January 2026

Total Providers

6K

in Idaho

Total Medicare Payment

$482.9M

Avg Payment / Provider

$76K

Total Services

12.2M

Idaho Performance Signals

Revenue per Provider

$76,276

-4.3% vs benchmark · national avg $79,744

Provider Market Share

0.5% of US

-73.1% vs benchmark · 6,331 providers

CCM Adoption

1.4%

-87.5% vs benchmark · national 11.3%

RPM Adoption

0.4%

-94.1% vs benchmark · national 6.5%

AWV Completion

8.4%

-51.9% vs benchmark · national 17.5%

Key Stats

6K
Total Providers(Idaho)
$76K
Avg Medicare Payment(per provider)
$482.9M
Total Medicare Payments
Nurse Practitioner
Top Specialty(994 providers)

How This Compares

#21 of 62
National rank by avg Medicare payment
-4%vs national average
Idaho Medicare Revenue

Top Opportunities

#1
Chronic Care Management (99490)
$7.4M potential
#2
Remote Patient Monitoring (99454)
$5.1M potential
#3
Annual Wellness Visits (G0438/G0439)
$3.4M potential
Peer group: 6,331 providers
Confidence: High
CMS Medicare Public Data 2024
Data year: 2024

How Idaho Compares

#21
of 62 states
-4%
vs national avg

vs Neighboring States

Idaho
$76K
Montana
$54K
-29%
Nevada
$108K
+42%
Oregon
$54K
-29%
Utah
$61K
-20%
Strongest Specialty
Nurse Practitioner
994 providers
Biggest Program Gap
CCM (99490)
1.4% adoption vs 11.3% national

Top Revenue Opportunities in Idaho

#1

Chronic Care Management (99490)

$7.4M
estimated annual opportunity

Only 1.4% of providers bill CCM vs 11.3% national average. 624 additional providers could adopt CCM to close this gap.

Current: 1.4%Target: 11.3%
high confidence· 624 providers
#2

Remote Patient Monitoring (99454)

$5.1M
estimated annual opportunity

RPM adoption is 0.4% vs 6.5% nationally. 385 providers could implement RPM programs.

Current: 0.4%Target: 6.5%
high confidence· 385 providers
#3

Annual Wellness Visits (G0438/G0439)

$3.4M
estimated annual opportunity

AWV completion at 8.4% trails the 17.5% national average. 574 additional providers could offer AWV services.

Current: 8.4%Target: 17.5%
high confidence· 574 providers

Market Opportunities by Specialty

Top 50 Providers in Idaho

ProviderPatientsMedicare $
Safeway Inc215,740$76.1M
Albertsons Llc82,404$29.0M
American Drug Stores Llc79,296$27.3M
Vons Companies Inc32,935$12.7M
Nai Saturn Eastern Llc34,376$12.6M
Acme Markets Inc28,811$9.5M
Randalls Food & Drugs Lp23,930$6.7M
Shaws Supermarkets Inc15,825$5.5M
Kyle ThompsonM.D.851$4.5M
Ali Torab ParhizM.D1,086$4.3M
Ananda WalaliyaddaM.D.347$3.9M
David BartelsDO439$3.5M
James EarlMD PHD779$3.1M
Clinton EllingsonMD809$2.7M
Danko MartincicMD300$2.6M
Svetlana MeierMD358$2.5M
Mikael LagwinskiMD462$2.2M
Darryl MoffettM.D.433$2.0M
County Of Ada3,553$2.0M
Eric RomriellDO717$1.7M
North Idaho Cataract & Laser Ctr933$1.7M
Kootenai County Emergency Medical Services System2,559$1.7M
Denton RobertsMD741$1.6M
Cory BrownD.P.M.235$1.5M
Eagle Eye Surgery And Laser Center Llc693$1.5M
Idaho Eye Center Pa852$1.5M
Shawn RichardsM.D898$1.4M
Robert FairbanksM.D.274$1.3M
Golden BucklandM.D.603$1.2M
Nathan WelchM.D.469$1.1M
Rm Lab Llc5,866$1.1M
Aaron WagnerM.D.224$1.1M
Carl OdomMD325$1.1M
Dustin DinningDO440$1.1M
Surgicare Center Of Idaho, Llc578$1.1M
Pleasant View Surgery Center, Llc66$1.0M
Alyssa HoehnM.D.627$1.0M
Magic Valley Paramedics L L C1,375$977K
Canyon County Ambulance District1,531$951K
Michael TaylorM.D.610$946K
Surgery Center Of Idaho Llc514$943K
Star Markets Company Inc3,033$938K
River View Surgery Center, Llc498$920K
Corbin JacobsM.D.130$915K
City Of Idaho Falls1,415$900K
Travis FrogleyFNP-C221$884K
Alison GranierM.D.803$843K
Idaho Endoscopy Center Llc827$788K
Pacific Cataract And Laser Institute, Inc., P.C.404$787K
Drew ThomasM.D.948$774K

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