South Dakota

Medicare Revenue Gap Analysis

3.0K

Medicare Providers

170.0K

Beneficiaries

$70.6K

Avg Missed/Provider

$213.2M

Total State Gap

Revenue Gap Breakdown

E&M Coding Gap

$20.0K/yr

Average undercoding gap from 99213→99214 shifts

CCM Revenue Gap

$22.6K/yr

7% adoption rate — national benchmark: 15%

RPM Revenue Gap

$15.5K/yr

5% adoption rate — national benchmark: 8%

AWV Revenue Gap

$9.9K/yr

50% completion rate — target: 70%+

BHI Revenue Gap

$5.6K/yr

Behavioral health integration opportunity

Top Cities in South Dakota

#1

Sioux Falls

1,240 providers

Est. gap: $74.4M

#2

Rapid City

580 providers

Est. gap: $34.8M

#3

Aberdeen

280 providers

Est. gap: $16.8M

#4

Brookings

180 providers

Est. gap: $10.8M

#5

Watertown

140 providers

Est. gap: $8.4M

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