North Carolina

Medicare Revenue Gap Analysis

28.4K

Medicare Providers

1.9M

Beneficiaries

$90.2K

Avg Missed/Provider

$2561.7M

Total State Gap

Revenue Gap Breakdown

E&M Coding Gap

$25.4K/yr

Average undercoding gap from 99213→99214 shifts

CCM Revenue Gap

$28.9K/yr

10% adoption rate — national benchmark: 15%

RPM Revenue Gap

$19.8K/yr

6% adoption rate — national benchmark: 8%

AWV Revenue Gap

$12.6K/yr

46% completion rate — target: 70%+

BHI Revenue Gap

$7.2K/yr

Behavioral health integration opportunity

Top Cities in North Carolina

Charlotte

6,240 providers

Est. gap: $478.4M

Raleigh

4,280 providers

Est. gap: $328.1M

Durham

3,240 providers

Est. gap: $248.4M

Winston-Salem

2,120 providers

Est. gap: $162.5M

Greensboro

1,840 providers

Est. gap: $141.1M

Top Specialties in North Carolina

Family Medicine

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Internal Medicine

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Cardiology

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Orthopedics

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Psychiatry

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Care Management Adoption

CCM Adoption

10%Target: 15%

RPM Adoption

6%Target: 10%

AWV Completion

46%Target: 70%

Related Billing Guides

CCM Billing Guide →RPM Billing Guide →AWV Billing Guide →E&M Coding Guide →BHI Billing Guide →

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