Rhode Island

Medicare Revenue Gap Analysis

4.3K

Medicare Providers

210.0K

Beneficiaries

$80.2K

Avg Missed/Provider

$343.3M

Total State Gap

Revenue Gap Breakdown

E&M Coding Gap

$22.6K/yr

Average undercoding gap from 99213→99214 shifts

CCM Revenue Gap

$25.7K/yr

9% adoption rate — national benchmark: 15%

RPM Revenue Gap

$17.6K/yr

5% adoption rate — national benchmark: 8%

AWV Revenue Gap

$11.2K/yr

48% completion rate — target: 70%+

BHI Revenue Gap

$6.4K/yr

Behavioral health integration opportunity

Top Cities in Rhode Island

#1

Providence

2,240 providers

Est. gap: $152.7M

#2

Warwick

580 providers

Est. gap: $39.5M

#3

Cranston

420 providers

Est. gap: $28.6M

#4

Newport

340 providers

Est. gap: $23.2M

#5

Pawtucket

280 providers

Est. gap: $19.1M

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