Find the $60K–$200K your family practice is leaving on the table.
Most independent family medicine clinics under-bill CCM, miss AWV add-ons, and refer out in-scope procedures. Our reports size every gap in dollars so you can prioritize, not guess.
What we see again and again in family medicine practices
- CCM/RPM enrollment is a fraction of what your panel could support
- Annual Wellness Visits are billed standalone instead of bundled with chronic visits
- Modifier 25 is either avoided (revenue loss) or overused (audit risk)
- Sports physicals, joint injections, and spirometry referred out despite in-house capacity
Family medicine reference data
Every report compares your numbers against published peer data. Sources include MGMA, CMS, and specialty-society reports.
| Metric | Reference value | Source |
|---|---|---|
| Median CCM enrollment rate (eligible Medicare patients) | 8–14% | MGMA + CMS |
| AWV completion rate, primary care median | 32% | CMS published |
| Revenue per established patient, FM median | $285–$340/yr | MGMA 2024 |
Recommended report order for family medicine
You don't need all four. Start with the one we recommend first — most owners stop there because it surfaces enough to act on for the next 90 days.
- 1
Chronic care revenue
$0Sizes your CCM, RPM, AWV, and TCM billing opportunity based on your patient panel.
- 2
CPT and billing review
$0Specialty-specific coding checklist with commonly missed codes, modifier traps, and a 30-day fix list.
- 3
Revenue expansion
$0Ranks your top 8–10 revenue expansion opportunities by specialty, staff, and payer mix.
- 4
Staff utilization
$0Identifies whether your NPs, PAs, and licensed staff are billing at full scope.
Common dollar findings in family medicine
Pulled from patterns we see across audits. Your numbers will differ, but the categories are remarkably consistent.
- CCM under-enrollment costing $8,400–$24,000/month in recurring revenue
- Missed G0439/G0438 wellness add-ons worth $18–$32K/year
- NP/PA panels at 58–72% utilization vs. 85%+ benchmark
- Outbound joint injection referrals worth $24K–$60K/year recoverable in-house
FAQ for family medicine owners
How does this differ from a billing consultant?+
A billing consultant works inside your EHR over 4–8 weeks for $8K+. Our reports use your reported aggregates plus MGMA/CMS benchmarks to provide an initial public-data screen, while a qualified full audit tests the opportunities against your billing data, so you can decide what's worth a deeper engagement.
We're already enrolled in CCM. Is the report still useful?+
Yes. Most enrolled practices capture 25–40% of eligible patients. The calculator sizes the remaining gap and models the staffing math to close it.