Delaware Medicare Revenue Analysis
CMS Medicare Physician & Other Practitioners data
Delaware has 5K Medicare providers who collectively received $434.2M in Medicare payments, averaging $95K per provider. Delaware providers earn moderate Medicare revenue per provider, with significant opportunity to capture additional revenue through program enrollment and coding optimization.
The most common specialty is Nurse Practitioner with 670 providers, followed by Physical Therapist in Private Practice (462) and Physician Assistant (416). Nurse Practitioner providers in Delaware average $36K annually, with room to grow through CCM, RPM, and AWV program adoption.
The largest Medicare provider concentration is in Newark (1,442 providers), with Wilmington and Dover 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
5K
in Delaware
Total Medicare Payment
$434.2M
Avg Payment / Provider
$95K
Total Services
11.8M
Delaware Performance Signals
Revenue per Provider
$95,220
+19.4% vs benchmark · national avg $79,744
Provider Market Share
0.4% of US
-80.6% vs benchmark · 4,560 providers
CCM Adoption
1.7%
-84.6% vs benchmark · national 11.3%
RPM Adoption
0.5%
-91.9% vs benchmark · national 6.5%
AWV Completion
10.7%
-38.9% vs benchmark · national 17.5%
Key Stats
How This Compares
Top Opportunities
How Delaware Compares
vs Neighboring States
Top Revenue Opportunities in Delaware
Chronic Care Management (99490)
Only 1.7% of providers bill CCM vs 11.3% national average. 435 additional providers could adopt CCM to close this gap.
Remote Patient Monitoring (99454)
RPM adoption is 0.5% vs 6.5% nationally. 271 providers could implement RPM programs.
Annual Wellness Visits (G0438/G0439)
AWV completion at 10.7% trails the 17.5% national average. 309 additional providers could offer AWV services.
Market Opportunities by Specialty
Top Specialties in Delaware
| Specialty | Providers | Avg Payment |
|---|---|---|
| Nurse Practitioner | 670 | $36K |
| Physical Therapist in Private Practice | 462 | $61K |
| Physician Assistant | 416 | $36K |
| Internal Medicine | 350 | $94K |
| Family Practice | 282 | $100K |
| Certified Registered Nurse Anesthetist (CRNA) | 184 | $14K |
| Emergency Medicine | 161 | $63K |
| Chiropractic | 150 | $18K |
| Optometry | 112 | $55K |
| Licensed Clinical Social Worker | 102 | $18K |
| Diagnostic Radiology | 100 | $165K |
| Mass Immunizer Roster Biller | 82 | $84K |
| General Surgery | 74 | $42K |
| Obstetrics & Gynecology | 74 | $14K |
| Anesthesiology | 73 | $36K |
| Cardiology | 72 | $390K |
| Psychiatry | 72 | $36K |
| Orthopedic Surgery | 62 | $222K |
| Ambulance Service Provider | 60 | $247K |
| Podiatry | 59 | $119K |
Top Cities in Delaware
Newark
Wilmington
Dover
Lewes
Milford
New Castle
Middletown
Seaford
Millsboro
Rehoboth Beach
Bear
Georgetown
Smyrna
Hockessin
Selbyville
Claymont
Millville
Laurel
Milton
Camden
Harrington
Ocean View
Delmar
Bethany Beach
Bridgeville
Greenville
Dover Afb
Top 50 Providers in Delaware
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