South Carolina

Medicare Revenue Gap Analysis

14.2K

Medicare Providers

1.1M

Beneficiaries

$90.8K

Avg Missed/Provider

$1289.4M

Total State Gap

Revenue Gap Breakdown

E&M Coding Gap

$25.8K/yr

Average undercoding gap from 99213→99214 shifts

CCM Revenue Gap

$29.1K/yr

8% adoption rate — national benchmark: 15%

RPM Revenue Gap

$20.0K/yr

5% adoption rate — national benchmark: 8%

AWV Revenue Gap

$12.7K/yr

43% completion rate — target: 70%+

BHI Revenue Gap

$7.3K/yr

Behavioral health integration opportunity

Top Cities in South Carolina

#1

Charleston

3,480 providers

Est. gap: $268.6M

#2

Columbia

2,640 providers

Est. gap: $203.8M

#3

Greenville

2,240 providers

Est. gap: $172.9M

#4

Myrtle Beach

1,120 providers

Est. gap: $86.4M

#5

Spartanburg

680 providers

Est. gap: $52.5M

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