U.S. Medical Coding Market

U.S. Medical Coding Market Size, Share, Growth Analysis, By Classification system(ICD, HCPS and CPT), By Component(In-house and outsourced) - Industry Forecast 2024-2031


Report ID: SQMIG35G2210 | Region: Country | Published Date: February, 2024
Pages: 157 | Tables: 60 | Figures: 75

U.S. Medical Coding Market Insights

U.S. Medical Coding Market size was valued at USD 18.4 billion in 2022 and is poised to grow from USD 20.17 billion in 2023 to USD 41.99 billion by 2031, growing at a CAGR of 9.6% in the forecast period (2024-2031).  

The U.S. medical coding market is poised for significant growth in the foreseeable future. Large financial losses occur as a result of billing errors, insurance fraud, and misinterpretations of medical documents. The growing prevalence of ineffective medical billing and revenue cycle management has created a higher demand for revenue cycle management solutions, including medical coding software and services. The adoption of digital technologies such as electronic health records, revenue cycle management software, mhealth applications, telehealth, and the ongoing efforts towards healthcare digitalization in the U.S. are also contributing to the positive expansion of the market. Medical coding is being increasingly employed in the revenue cycle management process, with new code revisions introduced to enhance flexibility and scalability. The implementation of the new ICD-11 coding system in January 2022, featuring numerous new chapters and support for electronic health records, is having a favorable impact on market growth. This revised coding system comprises approximately 55 thousand codes for the classification of disorders, diseases, injuries, and deaths. The Bureau of Labor Statistics, Office of Occupational Statistics and Employment Projections, estimates a 7% growth in the number of medical records and health information employees between 2021 and 2031. Certified medical coders are highly sought-after in the U.S., as there is an increasing demand for standardized medical documentation. The rising workload on healthcare staff and physicians for medical coding has led to the adoption of various automation solutions. For instance, a survey conducted by Athenahealth reveals that physicians spend an average of 90 minutes working overtime on coding. Consequently, there has been a rise in the utilization of computer-assisted coding solutions, which offer rapid, accurate, and efficient medical coding. According to a survey by 3M, computer-assisted coding can increase productivity by 11-30%. Additionally, the development of AI-enabled medical coding is projected to drive market growth. Healthcare spending in the U.S. is experiencing rapid growth, and hospital administration costs are notably high. As a result, healthcare organizations are under increasing pressure to deliver quality care while reducing costs. To address this challenge, healthcare providers are adopting medical coding software and outsourcing services, aiming to decrease administration costs and enhance return on investment. This adoption is anticipated to drive the market's growth.

US Medical Coding Market is poised to grow at a sustainable CAGR for the next forecast year

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U.S. Medical Coding Market size was valued at USD 18.4 billion in 2022 and is poised to grow from USD 20.17 billion in 2023 to USD 41.99 billion by 2031, growing at a CAGR of 9.6% in the forecast period (2024-2031).  

The competitive landscape of the U.S. medical coding market is characterized by a diverse range of service providers and software solutions catering to the growing demand for accurate and efficient medical coding processes. Key players in the market offer a variety of services, including medical coding software, outsourcing services, consulting, and training. These providers strive to differentiate themselves by offering advanced technologies, user-friendly interfaces, and comprehensive solutions that address the evolving needs of healthcare organizations. Additionally, partnerships and collaborations with healthcare stakeholders, such as hospitals, clinics, and insurance companies, are common strategies to enhance market presence and expand service offerings. As the market continues to grow, competition intensifies, driving innovation and the development of sophisticated coding solutions to meet the demands of the dynamic healthcare industry. 'STARTEK', 'Oracle', 'Maxim Healthcare Services', 'Parexel International Corporation', 'Aviacode Inc.', 'Verisk Analytics, Inc.', 'Medical Record Associates, LLC.', 'Optum', 'Change Healthcare', 'Exela Technologies', 'nThrive', 'Maxim Health Information Services', 'himagine solutions Inc.', 'M*Modal', 'TrustHCS', 'Dolbey', 'The Coding Network LLC', 'MRA Health Information Services', 'Peak Health Solutions', 'ezDI Inc.'

One key driver of the U.S. medical coding market is the increasing demand for accurate and standardized medical documentation. The healthcare industry relies on medical coding to ensure proper billing, reimbursement, and communication between healthcare providers and payers. With the growing emphasis on electronic health records and the need for streamlined healthcare processes, the demand for medical coding services and solutions has significantly increased.

One key market trend in the U.S. medical coding market is the increasing adoption of automation and artificial intelligence (AI) technologies. Healthcare organizations are leveraging advanced coding software and AI-powered tools to streamline the coding process, enhance accuracy, and improve productivity. Automation solutions, such as computer-assisted coding (CAC), are being widely adopted to assist coders in efficiently assigning appropriate codes to medical procedures and diagnoses. AI algorithms are being used to analyze medical documentation, extract relevant information, and suggest appropriate codes, reducing manual effort and potential errors. This trend is driven by the need for faster and more accurate coding processes, increased efficiency, and improved revenue cycle management in the healthcare industry.

The US has a highly developed healthcare system and a large market for revenue cycle management solutions. Factors such as increasing healthcare spending, a complex reimbursement landscape, and a strong focus on digitization and technology adoption in healthcare contribute to the dominance of the US market. Furthermore, the presence of major healthcare organizations, advanced infrastructure, and a favorable regulatory environment for revenue cycle management drive market growth in the US.

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U.S. Medical Coding Market

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