West Virginia Medicare Revenue Analysis
CMS Medicare Physician & Other Practitioners data
West Virginia has 7K Medicare providers who collectively received $347.0M in Medicare payments, averaging $50K per provider. With below-average per-provider Medicare revenue, West Virginia practices may have substantial untapped potential in care management programs and E&M coding optimization.
The most common specialty is Nurse Practitioner with 1,379 providers, followed by Physician Assistant (645) and Family Practice (622). Nurse Practitioner providers in West Virginia average $17K annually, with room to grow through CCM, RPM, and AWV program adoption.
The largest Medicare provider concentration is in Morgantown (1,245 providers), with Charleston and Huntington also serving as major healthcare hubs. Practices in these areas face competitive pressure, making revenue optimization through proper coding and program enrollment critical for financial performance.
Total Providers
7K
in West Virginia
Total Medicare Payment
$347.0M
Avg Payment / Provider
$50K
Total Services
8.9M
West Virginia Performance Signals
Revenue per Provider
$49,696
-37.7% vs benchmark · national avg $79,744
Provider Market Share
0.6% of US
-70.3% vs benchmark · 6,983 providers
CCM Adoption
1.3%
-88.8% vs benchmark · national 11.3%
RPM Adoption
0.1%
-98.0% vs benchmark · national 6.5%
AWV Completion
8.1%
-53.8% vs benchmark · national 17.5%
Key Stats
How This Compares
Top Opportunities
How West Virginia Compares
vs Neighboring States
Top Revenue Opportunities in West Virginia
Chronic Care Management (99490)
Only 1.3% of providers bill CCM vs 11.3% national average. 699 additional providers could adopt CCM to close this gap.
Remote Patient Monitoring (99454)
RPM adoption is 0.1% vs 6.5% nationally. 443 providers could implement RPM programs.
Annual Wellness Visits (G0438/G0439)
AWV completion at 8.1% trails the 17.5% national average. 657 additional providers could offer AWV services.
Market Opportunities by Specialty
Top Specialties in West Virginia
| Specialty | Providers | Avg Payment |
|---|---|---|
| Nurse Practitioner | 1,379 | $17K |
| Physician Assistant | 645 | $19K |
| Family Practice | 622 | $43K |
| Internal Medicine | 466 | $57K |
| Certified Registered Nurse Anesthetist (CRNA) | 354 | $6K |
| Physical Therapist in Private Practice | 333 | $43K |
| Emergency Medicine | 281 | $35K |
| Mass Immunizer Roster Biller | 237 | $27K |
| Optometry | 179 | $25K |
| Anesthesiology | 147 | $15K |
| Diagnostic Radiology | 143 | $92K |
| General Surgery | 138 | $33K |
| Ambulance Service Provider | 136 | $324K |
| Chiropractic | 124 | $12K |
| Psychiatry | 120 | $26K |
| Orthopedic Surgery | 110 | $74K |
| Hospitalist | 97 | $44K |
| Obstetrics & Gynecology | 95 | $11K |
| Ophthalmology | 79 | $375K |
| Cardiology | 79 | $118K |
Top Cities in West Virginia
Morgantown
Charleston
Huntington
Wheeling
Parkersburg
Beckley
Bridgeport
Martinsburg
South Charleston
Princeton
Weirton
Elkins
Fairmont
Hurricane
Vienna
Ronceverte
Logan
Barboursville
Lewisburg
Clarksburg
Glen Dale
Summersville
Bluefield
Weston
Buckhannon
Ripley
Ranson
Oak Hill
Keyser
Charles Town
Top 50 Providers in West Virginia
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