Kentucky Medicare Revenue Analysis
CMS Medicare Physician & Other Practitioners data
Kentucky has 18K Medicare providers who collectively received $988.0M in Medicare payments, averaging $56K per provider. With below-average per-provider Medicare revenue, Kentucky practices may have substantial untapped potential in care management programs and E&M coding optimization.
The most common specialty is Nurse Practitioner with 4,428 providers, followed by Physician Assistant (1,142) and Family Practice (1,138). Nurse Practitioner providers in Kentucky average $21K annually, with room to grow through CCM, RPM, and AWV program adoption.
The largest Medicare provider concentration is in Louisville (4,516 providers), with Lexington and Bowling Green 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.
Total Providers
18K
in Kentucky
Total Medicare Payment
$988.0M
Avg Payment / Provider
$56K
Total Services
27.7M
Kentucky Performance Signals
Revenue per Provider
$56,050
-29.7% vs benchmark · national avg $79,744
Provider Market Share
1.5% of US
-25.0% vs benchmark · 17,628 providers
CCM Adoption
1.6%
-85.4% vs benchmark · national 11.3%
RPM Adoption
0.1%
-97.9% vs benchmark · national 6.5%
AWV Completion
9.0%
-48.6% vs benchmark · national 17.5%
Key Stats
How This Compares
Top Opportunities
How Kentucky Compares
vs Neighboring States
Top Revenue Opportunities in Kentucky
Chronic Care Management (99490)
Only 1.6% of providers bill CCM vs 11.3% national average. 1,697 additional providers could adopt CCM to close this gap.
Remote Patient Monitoring (99454)
RPM adoption is 0.1% vs 6.5% nationally. 1,116 providers could implement RPM programs.
Annual Wellness Visits (G0438/G0439)
AWV completion at 9.0% trails the 17.5% national average. 1,496 additional providers could offer AWV services.
Market Opportunities by Specialty
Top Specialties in Kentucky
| Specialty | Providers | Avg Payment |
|---|---|---|
| Nurse Practitioner | 4,428 | $21K |
| Physician Assistant | 1,142 | $23K |
| Family Practice | 1,138 | $48K |
| Internal Medicine | 990 | $73K |
| Certified Registered Nurse Anesthetist (CRNA) | 891 | $9K |
| Physical Therapist in Private Practice | 883 | $36K |
| Emergency Medicine | 602 | $42K |
| Optometry | 514 | $27K |
| Mass Immunizer Roster Biller | 496 | $29K |
| Chiropractic | 455 | $9K |
| Anesthesiology | 388 | $27K |
| Diagnostic Radiology | 333 | $84K |
| General Surgery | 319 | $30K |
| Orthopedic Surgery | 294 | $91K |
| Hospitalist | 239 | $55K |
| Cardiology | 233 | $112K |
| Licensed Clinical Social Worker | 230 | $14K |
| Obstetrics & Gynecology | 223 | $12K |
| Ophthalmology | 187 | $452K |
| Ambulance Service Provider | 185 | $413K |
Top Cities in Kentucky
Louisville
Lexington
Bowling Green
Paducah
Owensboro
Edgewood
Ashland
Pikeville
Elizabethtown
Florence
Somerset
Hazard
London
Corbin
Madisonville
Danville
Crestview Hills
Glasgow
Richmond
Murray
Hopkinsville
Morehead
Georgetown
Frankfort
Henderson
Bardstown
Shelbyville
Campbellsville
Winchester
Prestonsburg
Top 50 Providers in Kentucky
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