Massachusetts Medicare Revenue Analysis
CMS Medicare Physician & Other Practitioners data
Massachusetts has 36K Medicare providers who collectively received $2411.9M in Medicare payments, averaging $68K per provider. Massachusetts 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 5,123 providers, followed by Internal Medicine (3,882) and Physician Assistant (2,736). Nurse Practitioner providers in Massachusetts average $27K annually, with room to grow through CCM, RPM, and AWV program adoption.
The largest Medicare provider concentration is in Boston (9,408 providers), with Worcester and Springfield 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
36K
in Massachusetts
Total Medicare Payment
$2411.9M
Avg Payment / Provider
$68K
Total Services
56.7M
Massachusetts Performance Signals
Revenue per Provider
$67,800
-15.0% vs benchmark · national avg $79,744
Provider Market Share
3.0% of US
+51.3% vs benchmark · 35,573 providers
CCM Adoption
0.6%
-94.4% vs benchmark · national 11.3%
RPM Adoption
0.2%
-97.0% vs benchmark · national 6.5%
AWV Completion
9.4%
-46.1% vs benchmark · national 17.5%
Key Stats
How This Compares
Top Opportunities
How Massachusetts Compares
vs Neighboring States
Top Revenue Opportunities in Massachusetts
Chronic Care Management (99490)
Only 0.6% of providers bill CCM vs 11.3% national average. 3,783 additional providers could adopt CCM to close this gap.
Remote Patient Monitoring (99454)
RPM adoption is 0.2% vs 6.5% nationally. 2,230 providers could implement RPM programs.
Annual Wellness Visits (G0438/G0439)
AWV completion at 9.4% trails the 17.5% national average. 2,861 additional providers could offer AWV services.
Market Opportunities by Specialty
Top Specialties in Massachusetts
| Specialty | Providers | Avg Payment |
|---|---|---|
| Nurse Practitioner | 5,123 | $27K |
| Internal Medicine | 3,882 | $60K |
| Physician Assistant | 2,736 | $25K |
| Physical Therapist in Private Practice | 1,979 | $41K |
| Emergency Medicine | 1,280 | $49K |
| Anesthesiology | 1,241 | $26K |
| Family Practice | 1,239 | $50K |
| Diagnostic Radiology | 1,084 | $98K |
| Psychiatry | 953 | $29K |
| Licensed Clinical Social Worker | 925 | $19K |
| Certified Registered Nurse Anesthetist (CRNA) | 837 | $9K |
| Optometry | 792 | $25K |
| Cardiology | 693 | $115K |
| Chiropractic | 678 | $18K |
| Neurology | 627 | $56K |
| Mass Immunizer Roster Biller | 616 | $113K |
| Hospitalist | 591 | $53K |
| Ophthalmology | 553 | $361K |
| Obstetrics & Gynecology | 537 | $16K |
| Pathology | 532 | $68K |
Top Cities in Massachusetts
Boston
Worcester
Springfield
Burlington
Cambridge
Fall River
Brockton
Newton
Hyannis
Pittsfield
Framingham
Plymouth
Beverly
Weymouth
Quincy
Salem
Lawrence
Brighton
Peabody
Lowell
Brookline
New Bedford
Leominster
Waltham
Northampton
Wellesley
Westwood
Danvers
Norwood
Milford
Top 50 Providers in Massachusetts
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