U.S. Medical Coding Market Outlook 2028

United States (U.S.) Medical Coding Market Analysis 2019-2028

Medical coding is the translation of healthcare procedures, diagnoses, medicals services, and equipment into universal medical alphanumeric codes by medical transcriptionists. The United States (U.S.) medical coding market is forecasted to grow with a CAGR of 8.8% during the forecast period, i.e., 2020-2028. Factors such as the advent in data enrichment tools, such as mobile health or mHealth and electronic health records (EHRs), among others, coupled with the growing utilization of data analytics, and the rising implementation of IT in the healthcare sector for real-time data monitoring, are anticipated to contribute to the market growth during the forecast period. Additionally, factors such as the growing need for streamlining revenue cycle management in healthcare organizations, along with the opportunities generated for medical coding backed by the rising number of healthcare frauds, are anticipated to drive the market growth in the coming years.

The United States (U.S.) medical coding market consists of numerous segments, which include segmentation by service mode, solution, classification, patient type and by end-user. The patient type segment is further divided into inpatient and outpatient, out of which, the inpatient segment with respect to hospitals registered the largest market share. Inpatient medical coding deals with the maintenance of the extensive and intricate patient records. These records also include diagnostic tests and treatments that are conducted with the patients during their stay in the hospital.

Some of the prominent leaders in the United States (U.S.) medical coding market are 3M, Conifer Health Solutions, LLC, Coding Network, Maxim Healthcare Group, Aviacode Inc., Managed Outsource Solutions, and I-conic Solutions.

United States (U.S.) Medical Coding Market

1. Introduction

1.1. Market Definition
1.2. Market Segmentation
1.3. Product Overview

2. Assumptions and Acronyms

3. Research Methodology

3.1. Research Process
3.1.1. Primary Research
3.1.2. Secondary Research
3.1.3. Market Size Estimation

4. Executive Summary- US Medical Coding Market5. Regulatory Landscape

6. Market Dynamics

6.1. Drivers
6.2. Restraints
6.3. Trends
6.4. Opportunities

7. Study on Risk Adjustment Coding8. Patient Analysis9. End-User Analysis10. Growth Opportunity Analysis for Business Development11. Average Pricing Analysis12. Impact of Covid-19 on the US Medical Coding Market13. Comparative Analysis of In-House Vs Outsourced Coding Costs14. Cost Analysis: Cost Per Hour for In-House vs Outsourced Coding

15. Competitive Landscape

15.1. Competitive Benchmarking of Key Players
15.2. Market Share Analysis
15.3. Company Profiles
15.3.1. Aviacode Inc.
15.3.2. Maxim Healthcare Group
15.3.3. Coding Network
15.3.4. Conifer Health Solutions, LLC
15.3.5. I-Conic Solutions
15.3.6. Managed Outsource Solutions
15.3.7. 3M

16. US Medical Coding Outlook

16.1. Market Overview
16.1.1. By Value (USD Million), 2019-2028F
16.2. Market Segmentation
16.2.1. By End-User
16.2.1.1. Hospitals, Diagnostic Centers, Others, 2019-2028F (USD Million)
16.2.2. By Service Mode
16.2.2.1. In-House, Out-Sourced W.R.T. Hospitals, 2019-2028F (USD Million)
16.2.2.2. In-House, Out-Sourced W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
16.2.2.3. In-House, Out-Sourced W.R.T. Others, 2019-2028F (USD Million)
16.2.3. By Patient-Type
16.2.3.1. Inpatient, Outpatient W.R.T. Hospitals, 2019-2028F (USD Million)
16.2.3.2. Inpatient, Outpatient W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
16.2.3.3. Inpatient, Outpatient W.R.T. Others, 2019-2028F (USD Million)
16.2.4. By Classification
16.2.4.1. International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Hospitals, 2019-2028F (USD Million)
16.2.4.2. International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
16.2.4.3. International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Others, 2019-2028F (USD Million)
16.2.5. By Solution
16.2.5.1. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Hospitals, 2019-2028F (USD Million)
16.2.5.2. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
16.2.5.3. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Others, 2019-2028F (USD Million)
16.2.6. By Region
16.2.6.1. Northeast US, Southeast US, Southwest US, Midwest US, West US, 2019-2028F (USD Million)

17. Northeast US Medical Coding Market

17.1. Market Value (USD Million)
17.2. Market Segmentation
17.2.1. By End-User
17.2.1.1. Hospitals, Diagnostic Centers, Others, 2019-2028F (USD Million)
17.2.2. By Service Mode
17.2.2.1. In-House, Out-Sourced W.R.T. Hospitals, 2019-2028F (USD Million)
17.2.2.2. In-House, Out-Sourced W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
17.2.2.3. In-House, Out-Sourced W.R.T. Others, 2019-2028F (USD Million)
17.2.3. By Patient-Type
17.2.3.1. Inpatient, Outpatient W.R.T. Hospitals, 2019-2028F (USD Million)
17.2.3.2. Inpatient, Outpatient W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
17.2.3.3. Inpatient, Outpatient W.R.T. Others, 2019-2028F (USD Million)
17.2.4. By Classification
17.2.4.1. International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Hospitals, 2019-2028F (USD Million)
17.2.4.2. International Classification of Diseases (ICD), Current Procedural Terminology (Cpt), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
17.2.4.3. International Classification of Diseases (ICD), Current Procedural Terminology (Cpt), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Others, 2019-2028F (USD Million)
17.2.5. By Solution
17.2.5.1. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Hospitals, 2019-2028F (USD Million)
17.2.5.2. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
17.2.5.3. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Others, 2019-2028F (USD Million)
17.2.6. By States
17.2.6.1. New York, New Jersey, Pennsylvania, Massachusetts, Maryland, Rest of Northeast US, 2019-2028F (USD Million)

18. Southeast US Medical Coding Market

18.1. Market Value (USD Million)
18.2. Market Segmentation
18.2.1. By End-User
18.2.1.1. Hospitals, Diagnostic Centers, Others, 2019-2028F (USD Million)
18.2.2. By Service Mode
18.2.2.1. In-House, Out-Sourced W.R.T. Hospitals, 2019-2028F (USD Million)
18.2.2.2. In-House, Out-Sourced W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
18.2.2.3. In-House, Out-Sourced W.R.T. Others, 2019-2028F (USD Million)
18.2.3. By Patient-Type
18.2.3.1. Inpatient, Outpatient W.R.T. Hospitals, 2019-2028F (USD Million)
18.2.3.2. Inpatient, Outpatient W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
18.2.3.3. Inpatient, Outpatient W.R.T. Others, 2019-2028F (USD Million)
18.2.4. By Classification
18.2.4.1. International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Hospitals, 2019-2028F (USD Million)
18.2.4.2. International Classification of Diseases (ICD), Current Procedural Terminology (Cpt), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
18.2.4.3. International Classification of Diseases (ICD), Current Procedural Terminology (Cpt), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Others, 2019-2028F (USD Million)
18.2.5. By Solution
18.2.5.1. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Hospitals, 2019-2028F (USD Million)
18.2.5.2. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
18.2.5.3. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Others, 2019-2028F (USD Million)
18.2.6. By States
18.2.6.1. Tennessee, South Carolina, Florida, Virginia, Georgia, Rest of Southeast US, 2019-2028F (USD Million)

19. Southwest US Medical Coding Market

19.1. Market Value (USD Million)
19.2. Market Segmentation
19.2.1. By End-User
19.2.1.1. Hospitals, Diagnostic Centers, Others, 2019-2028F (USD Million)
19.2.2. By Service Mode
19.2.2.1. In-House, Out-Sourced W.R.T. Hospitals, 2019-2028F (USD Million)
19.2.2.2. In-House, Out-Sourced W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
19.2.2.3. In-House, Out-Sourced W.R.T. Others, 2019-2028F (USD Million)
19.2.3. By Patient-Type
19.2.3.1. Inpatient, Outpatient W.R.T. Hospitals, 2019-2028F (USD Million)
19.2.3.2. Inpatient, Outpatient W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
19.2.3.3. Inpatient, Outpatient W.R.T. Others, 2019-2028F (USD Million)
19.2.4. By Classification
19.2.4.1. International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Hospitals, 2019-2028F (USD Million)
19.2.4.2. International Classification of Diseases (ICD), Current Procedural Terminology (Cpt), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
19.2.4.3. International Classification of Diseases (ICD), Current Procedural Terminology (Cpt), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Others, 2019-2028F (USD Million)
19.2.5. By Solution
19.2.5.1. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Hospitals, 2019-2028F (USD Million)
19.2.5.2. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
19.2.5.3. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Others, 2019-2028F (USD Million)
19.2.6. By States
19.2.6.1. Arizona, Texas, Oklahoma, 2019-2028F (USD Million)

20. Midwest US Medical Coding Market

20.1. Market Value (USD Million)
20.2. Market Segmentation
20.2.1. By End-User
20.2.1.1. Hospitals, Diagnostic Centers, Others, 2019-2028F (USD Million)
20.2.2. By Service Mode
20.2.2.1. In-House, Out-Sourced W.R.T. Hospitals, 2019-2028F (USD Million)
20.2.2.2. In-House, Out-Sourced W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
20.2.2.3. In-House, Out-Sourced W.R.T. Others, 2019-2028F (USD Million)
20.2.3. By Patient-Type
20.2.3.1. Inpatient, Outpatient W.R.T. Hospitals, 2019-2028F (USD Million)
20.2.3.2. Inpatient, Outpatient W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
20.2.3.3. Inpatient, Outpatient W.R.T. Others, 2019-2028F (USD Million)
20.2.4. By Classification
20.2.4.1. International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Hospitals, 2019-2028F (USD Million)
20.2.4.2. International Classification of Diseases (ICD), Current Procedural Terminology (Cpt), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
20.2.4.3. International Classification of Diseases (ICD), Current Procedural Terminology (Cpt), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Others, 2019-2028F (USD Million)
20.2.5. By Solution
20.2.5.1. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Hospitals, 2019-2028F (USD Million)
20.2.5.2. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
20.2.5.3. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Others, 2019-2028F (USD Million)
20.2.6. By States
20.2.6.1. Minnesota, Illinois, Ohio, Wisconsin, Michigan, Rest of Midwest US, 2019-2028F (USD Million)

21. West US Medical Coding Market

21.1. Market Value (USD Million)
21.2. Market Segmentation
21.2.1. By End-User
21.2.1.1. Hospitals, Diagnostic Centers, Others, 2019-2028F (USD Million)
21.2.2. By Service Mode
21.2.2.1. In-House, Out-Sourced W.R.T. Hospitals, 2019-2028F (USD Million)
21.2.2.2. In-House, Out-Sourced W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
21.2.2.3. In-House, Out-Sourced W.R.T. Others, 2019-2028F (USD Million)
21.2.3. By Patient-Type
21.2.3.1. Inpatient, Outpatient W.R.T. Hospitals, 2019-2028F (USD Million)
21.2.3.2. Inpatient, Outpatient W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
21.2.3.3. Inpatient, Outpatient W.R.T. Others, 2019-2028F (USD Million)
21.2.4. By Classification
21.2.4.1. International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Hospitals, 2019-2028F (USD Million)
21.2.4.2. International Classification of Diseases (ICD), Current Procedural Terminology (Cpt), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
21.2.4.3. International Classification of Diseases (ICD), Current Procedural Terminology (Cpt), Healthcare Common Procedure Code System (HCPCS), International Classification of Functioning, Disability & Health (ICF), Diagnosis Related Groups W.R.T. Others, 2019-2028F (USD Million)
21.2.5. By Solution
21.2.5.1. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Hospitals, 2019-2028F (USD Million)
21.2.5.2. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Diagnostic Centers, 2019-2028F (USD Million)
21.2.5.3. Professional Fee Coding, Facility Coding, Emergency Department Medical Coding, Risk Adjustment Coding, Other Coding Solutions W.R.T. Others, 2019-2028F (USD Million)
21.2.6. By States
21.2.6.1. California, Alaska, Washington, Oregon, Rest of West US, 2019-2028F (USD Million)

22. Analyst’s Review

Companies Mentioned

3M
Conifer Health Solutions LLC
Coding Network
Maxim Healthcare Group
Aviacode Inc.
Managed Outsource Solutions
I-conic Solutions

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