California Medicare Revenue Analysis
CMS Medicare Physician & Other Practitioners data
California has 93K Medicare providers who collectively received $11525.5M in Medicare payments, averaging $123K per provider. This places California above the national average in per-provider Medicare revenue, suggesting a competitive healthcare market with strong reimbursement patterns.
The most common specialty is Internal Medicine with 9,189 providers, followed by Nurse Practitioner (7,134) and Family Practice (6,986). Internal Medicine providers in California average $102K in annual Medicare payments — a high-revenue specialty that often benefits from E&M coding optimization and care management program enrollment.
The largest Medicare provider concentration is in Los Angeles (6,943 providers), with San Diego and San Francisco 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
93K
in California
Total Medicare Payment
$11525.5M
Avg Payment / Provider
$123K
Total Services
268.1M
California Performance Signals
Revenue per Provider
$123,270
+54.6% vs benchmark · national avg $79,744
Provider Market Share
8.0% of US
+100.0% vs benchmark · 93,498 providers
CCM Adoption
1.1%
-89.9% vs benchmark · national 11.3%
RPM Adoption
0.8%
-88.1% vs benchmark · national 6.5%
AWV Completion
8.4%
-51.7% vs benchmark · national 17.5%
Key Stats
How This Compares
Top Opportunities
How California Compares
vs Neighboring States
Top Revenue Opportunities in California
Chronic Care Management (99490)
Only 1.1% of providers bill CCM vs 11.3% national average. 9,470 additional providers could adopt CCM to close this gap.
Remote Patient Monitoring (99454)
RPM adoption is 0.8% vs 6.5% nationally. 5,326 providers could implement RPM programs.
Annual Wellness Visits (G0438/G0439)
AWV completion at 8.4% trails the 17.5% national average. 8,441 additional providers could offer AWV services.
Market Opportunities by Specialty
Top Specialties in California
| Specialty | Providers | Avg Payment |
|---|---|---|
| Internal Medicine | 9,189 | $102K |
| Nurse Practitioner | 7,134 | $45K |
| Family Practice | 6,986 | $65K |
| Physical Therapist in Private Practice | 6,585 | $59K |
| Physician Assistant | 5,776 | $38K |
| Emergency Medicine | 4,860 | $42K |
| Anesthesiology | 3,586 | $27K |
| Diagnostic Radiology | 3,206 | $136K |
| Mass Immunizer Roster Biller | 2,501 | $70K |
| Chiropractic | 2,473 | $16K |
| Optometry | 2,228 | $27K |
| Ophthalmology | 1,955 | $396K |
| Psychiatry | 1,902 | $42K |
| Cardiology | 1,814 | $290K |
| Orthopedic Surgery | 1,810 | $115K |
| Hospitalist | 1,653 | $59K |
| General Surgery | 1,555 | $53K |
| Neurology | 1,515 | $102K |
| Psychologist, Clinical | 1,488 | $55K |
| Obstetrics & Gynecology | 1,437 | $22K |
Top Cities in California
Los Angeles
San Diego
San Francisco
Sacramento
Stanford
Fresno
Orange
San Jose
Bakersfield
Torrance
Oakland
Santa Monica
Long Beach
La Jolla
Palo Alto
Walnut Creek
Newport Beach
Loma Linda
Riverside
Modesto
Santa Barbara
Pasadena
Irvine
Beverly Hills
West Hollywood
Santa Rosa
Glendale
Roseville
Ventura
Stockton
Top 50 Providers in California
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