Texas

Medicare Revenue Gap Analysis

72.8K

Medicare Providers

4.3M

Beneficiaries

$106.8K

Avg Missed/Provider

$7775.0M

Total State Gap

Revenue Gap Breakdown

E&M Coding Gap

$30.2K/yr

Average undercoding gap from 99213→99214 shifts

CCM Revenue Gap

$34.2K/yr

10% adoption rate — national benchmark: 15%

RPM Revenue Gap

$23.5K/yr

6% adoption rate — national benchmark: 8%

AWV Revenue Gap

$15.0K/yr

44% completion rate — target: 70%+

BHI Revenue Gap

$8.5K/yr

Behavioral health integration opportunity

Top Cities in Texas

#1

Houston

16,800 providers

Est. gap: $1525.1M

#2

Dallas

12,400 providers

Est. gap: $1125.7M

#3

San Antonio

7,840 providers

Est. gap: $711.7M

#4

Austin

5,680 providers

Est. gap: $515.6M

#5

Fort Worth

4,240 providers

Est. gap: $384.9M

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