North Carolina Medicare Revenue Analysis
CMS Medicare Physician & Other Practitioners data
North Carolina has 40K Medicare providers who collectively received $2692.0M in Medicare payments, averaging $67K per provider. North Carolina 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 6,255 providers, followed by Physician Assistant (5,629) and Family Practice (2,646). Nurse Practitioner providers in North Carolina average $26K annually, with room to grow through CCM, RPM, and AWV program adoption.
The largest Medicare provider concentration is in Charlotte (4,977 providers), with Raleigh and Durham 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
40K
in North Carolina
Total Medicare Payment
$2692.0M
Avg Payment / Provider
$67K
Total Services
86.9M
North Carolina Performance Signals
Revenue per Provider
$66,914
-16.1% vs benchmark · national avg $79,744
Provider Market Share
3.4% of US
+71.2% vs benchmark · 40,231 providers
CCM Adoption
1.9%
-83.5% vs benchmark · national 11.3%
RPM Adoption
0.3%
-95.0% vs benchmark · national 6.5%
AWV Completion
10.4%
-40.5% vs benchmark · national 17.5%
Key Stats
How This Compares
Top Opportunities
How North Carolina Compares
vs Neighboring States
Top Revenue Opportunities in North Carolina
Chronic Care Management (99490)
Only 1.9% 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 0.3% vs 6.5% nationally. 2,471 providers could implement RPM programs.
Annual Wellness Visits (G0438/G0439)
AWV completion at 10.4% trails the 17.5% national average. 2,845 additional providers could offer AWV services.
Market Opportunities by Specialty
Top Specialties in North Carolina
| Specialty | Providers | Avg Payment |
|---|---|---|
| Nurse Practitioner | 6,255 | $26K |
| Physician Assistant | 5,629 | $24K |
| Family Practice | 2,646 | $53K |
| Internal Medicine | 2,439 | $74K |
| Physical Therapist in Private Practice | 2,309 | $34K |
| Certified Registered Nurse Anesthetist (CRNA) | 1,786 | $8K |
| Emergency Medicine | 1,430 | $37K |
| Mass Immunizer Roster Biller | 1,054 | $42K |
| Diagnostic Radiology | 1,002 | $95K |
| Anesthesiology | 941 | $21K |
| Optometry | 922 | $31K |
| Hospitalist | 882 | $44K |
| Chiropractic | 749 | $13K |
| Orthopedic Surgery | 735 | $89K |
| General Surgery | 650 | $34K |
| Licensed Clinical Social Worker | 629 | $15K |
| Obstetrics & Gynecology | 614 | $13K |
| Psychiatry | 579 | $23K |
| Cardiology | 570 | $133K |
| Ophthalmology | 490 | $469K |
Top Cities in North Carolina
Charlotte
Raleigh
Durham
Winston Salem
Wilmington
Greensboro
Asheville
Chapel Hill
Greenville
Fayetteville
Concord
Cary
Gastonia
Hickory
Pinehurst
High Point
Hendersonville
New Bern
Huntersville
Mooresville
Burlington
Statesville
Goldsboro
Jacksonville
Matthews
Shelby
Monroe
Rocky Mount
Salisbury
Lumberton
Top 50 Providers in North Carolina
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