Virginia

Medicare Revenue Gap Analysis

24.8K

Medicare Providers

1.5M

Beneficiaries

$88.6K

Avg Missed/Provider

$2197.3M

Total State Gap

Revenue Gap Breakdown

E&M Coding Gap

$25.0K/yr

Average undercoding gap from 99213→99214 shifts

CCM Revenue Gap

$28.4K/yr

10% adoption rate — national benchmark: 15%

RPM Revenue Gap

$19.5K/yr

6% adoption rate — national benchmark: 8%

AWV Revenue Gap

$12.4K/yr

47% completion rate — target: 70%+

BHI Revenue Gap

$7.1K/yr

Behavioral health integration opportunity

Top Cities in Virginia

#1

Richmond

4,680 providers

Est. gap: $352.5M

#2

Virginia Beach

2,840 providers

Est. gap: $213.9M

#3

Fairfax

2,480 providers

Est. gap: $186.8M

#4

Charlottesville

1,840 providers

Est. gap: $138.6M

#5

Norfolk

1,620 providers

Est. gap: $122.0M

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