West Virginia

Medicare Revenue Gap Analysis

5.5K

Medicare Providers

420.0K

Beneficiaries

$98.4K

Avg Missed/Provider

$539.2M

Total State Gap

Revenue Gap Breakdown

E&M Coding Gap

$28.2K/yr

Average undercoding gap from 99213→99214 shifts

CCM Revenue Gap

$31.5K/yr

6% adoption rate — national benchmark: 15%

RPM Revenue Gap

$21.6K/yr

3% adoption rate — national benchmark: 8%

AWV Revenue Gap

$13.8K/yr

38% completion rate — target: 70%+

BHI Revenue Gap

$7.9K/yr

Behavioral health integration opportunity

Top Cities in West Virginia

#1

Charleston

1,640 providers

Est. gap: $137.2M

#2

Morgantown

1,080 providers

Est. gap: $90.3M

#3

Huntington

820 providers

Est. gap: $68.6M

#4

Wheeling

480 providers

Est. gap: $40.1M

#5

Parkersburg

380 providers

Est. gap: $31.8M

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