Wisconsin

Medicare Revenue Gap Analysis

17.4K

Medicare Providers

1.1M

Beneficiaries

$76.8K

Avg Missed/Provider

$1336.3M

Total State Gap

Revenue Gap Breakdown

E&M Coding Gap

$21.6K/yr

Average undercoding gap from 99213→99214 shifts

CCM Revenue Gap

$24.6K/yr

10% adoption rate — national benchmark: 15%

RPM Revenue Gap

$16.9K/yr

6% adoption rate — national benchmark: 8%

AWV Revenue Gap

$10.8K/yr

52% completion rate — target: 70%+

BHI Revenue Gap

$6.1K/yr

Behavioral health integration opportunity

Top Cities in Wisconsin

#1

Milwaukee

4,240 providers

Est. gap: $276.8M

#2

Madison

3,480 providers

Est. gap: $227.2M

#3

Green Bay

1,240 providers

Est. gap: $80.9M

#4

Marshfield

840 providers

Est. gap: $54.8M

#5

Waukesha

720 providers

Est. gap: $47.0M

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