Massachusetts

Medicare Revenue Gap Analysis

28.4K

Medicare Providers

1.3M

Beneficiaries

$82.4K

Avg Missed/Provider

$2340.2M

Total State Gap

Revenue Gap Breakdown

E&M Coding Gap

$22.8K/yr

Average undercoding gap from 99213→99214 shifts

CCM Revenue Gap

$26.4K/yr

12% adoption rate — national benchmark: 15%

RPM Revenue Gap

$18.1K/yr

7% adoption rate — national benchmark: 8%

AWV Revenue Gap

$11.5K/yr

54% completion rate — target: 70%+

BHI Revenue Gap

$6.6K/yr

Behavioral health integration opportunity

Top Cities in Massachusetts

#1

Boston

9,240 providers

Est. gap: $647.2M

#2

Worcester

2,120 providers

Est. gap: $148.5M

#3

Springfield

1,480 providers

Est. gap: $103.7M

#4

Cambridge

1,240 providers

Est. gap: $86.8M

#5

Burlington

880 providers

Est. gap: $61.6M

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