Pennsylvania Medicare Revenue Analysis
CMS Medicare Physician & Other Practitioners data
Pennsylvania has 58K Medicare providers who collectively received $3755.6M in Medicare payments, averaging $65K per provider. Pennsylvania 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 6,828 providers, followed by Physician Assistant (5,960) and Internal Medicine (4,217). Nurse Practitioner providers in Pennsylvania average $23K annually, with room to grow through CCM, RPM, and AWV program adoption.
The largest Medicare provider concentration is in Philadelphia (8,952 providers), with Pittsburgh and Allentown 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
58K
in Pennsylvania
Total Medicare Payment
$3755.6M
Avg Payment / Provider
$65K
Total Services
110.7M
Pennsylvania Performance Signals
Revenue per Provider
$64,680
-18.9% vs benchmark · national avg $79,744
Provider Market Share
4.9% of US
+100.0% vs benchmark · 58,065 providers
CCM Adoption
0.9%
-92.2% vs benchmark · national 11.3%
RPM Adoption
0.3%
-96.1% vs benchmark · national 6.5%
AWV Completion
9.1%
-48.0% vs benchmark · national 17.5%
Key Stats
How This Compares
Top Opportunities
How Pennsylvania Compares
vs Neighboring States
Top Revenue Opportunities in Pennsylvania
Chronic Care Management (99490)
Only 0.9% of providers bill CCM vs 11.3% national average. 6,030 additional providers could adopt CCM to close this gap.
Remote Patient Monitoring (99454)
RPM adoption is 0.3% vs 6.5% nationally. 3,609 providers could implement RPM programs.
Annual Wellness Visits (G0438/G0439)
AWV completion at 9.1% trails the 17.5% national average. 4,866 additional providers could offer AWV services.
Market Opportunities by Specialty
Top Specialties in Pennsylvania
| Specialty | Providers | Avg Payment |
|---|---|---|
| Nurse Practitioner | 6,828 | $23K |
| Physician Assistant | 5,960 | $18K |
| Internal Medicine | 4,217 | $59K |
| Family Practice | 4,069 | $52K |
| Physical Therapist in Private Practice | 2,953 | $50K |
| Emergency Medicine | 2,594 | $39K |
| Certified Registered Nurse Anesthetist (CRNA) | 2,500 | $8K |
| Chiropractic | 1,663 | $13K |
| Anesthesiology | 1,656 | $22K |
| Mass Immunizer Roster Biller | 1,582 | $54K |
| Diagnostic Radiology | 1,548 | $85K |
| Optometry | 1,439 | $29K |
| Hospitalist | 1,119 | $53K |
| Cardiology | 1,045 | $129K |
| Psychiatry | 1,003 | $28K |
| General Surgery | 991 | $31K |
| Podiatry | 951 | $82K |
| Orthopedic Surgery | 937 | $101K |
| Obstetrics & Gynecology | 928 | $15K |
| Ophthalmology | 799 | $445K |
Top Cities in Pennsylvania
Philadelphia
Pittsburgh
Allentown
Bethlehem
York
Lancaster
Erie
Hershey
Danville
Harrisburg
Scranton
Wilkes Barre
West Chester
Altoona
State College
Chambersburg
Williamsport
Wynnewood
Bryn Mawr
Abington
Camp Hill
Monroeville
Wexford
West Reading
Sayre
Johnstown
Langhorne
Greensburg
Doylestown
Mechanicsburg
Top 50 Providers in Pennsylvania
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