United States Medical Coding Market Outlook 2031
The United States medical coding market size was valued at USD 19.18 billion in 2022 and is projected to reach USD 38.98 billion by 2031, expanding at a CAGR of 8.2% during the forecast period, 2023-2031. The growth of the market is attributed to the rising insurance frauds and issues due to misinterpretations of medical documents.
Medical coding is the translation of medical equipments, healthcare diagnosis, medical services, and procedures into standard medical alphanumeric codes. The process and diagnoses codes are taken from medical record documentation, such as laboratory records, transcription of physician's notes, and radiologic results.
Medical coding expert’s help in confirming the codes are written properly during the medical billing procedure, which includes creating a claim to be paid by insurance carriers, extracting the information from documentation, and assigning the appropriate codes.
According to the staffing firm Randstad U.S., certified medical coder is one of the much hunted job in the US. Implementing this universal coding system offer various benefits to the healthcare and insurance sector, such as more efficient research and analysis to track health trends, more seamless transfer of medical records, streamlined billing procedure, and easy patient’s disease diagnosis.
The COVID-19 pandemic outbreak had positive impact on the market. During the pandemic, healthcare sector shifted its focus to importance of documentation during any medical service transaction. Additionally, surging COVID cases, changing reimbursement policies, and growing development of new codes for COVID – 19 increased the demand for medical coding services.
United States Medical Coding Market Trends, Drivers, Restraints, and Opportunities
- Growing use of medical coding and billing procedure in revenue cycle management is one of the key factors driving the market growth.
- Rising demand of computer assisted medical coding as it offers more accuracy, transparency, enhances productivity, provides traceability, reduces cost, and compliance is projected to boost the market during the forecast period.
- Changing regulations and concern over data security acts as a major challenge that can restrict the market growth in the coming years.
- Lack of information technology professionals in healthcare sector is expected to hamper the market growth during the projected timeline.
- Surging impact of social media on healthcare sector and development of new technologies, such as Artificial Intelligence assisted medical coding is anticipated to create significant growth opportunities for the market.
Scope of The United States Medical Coding Market Report
The report on the U.S. medical coding market includes an assessment of the market, trends, segments, and regional markets. Overview and dynamics have also been included in the report.
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Attributes
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Details
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Report Title
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Medical Coding Market - United States Industry Analysis, Growth, Share, Size, Trends, and Forecast
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Base Year
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2022
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Historic Data
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2016–2021
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Forecast Period
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2023–2031
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Segmentation
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Components (Outsourced and In-house) and Classification Systems (Healthcare Common Procedure Coding System, Current Procedural Terminology, and International Classification Of Diseases)
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Country
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United States
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Report Coverage
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Company Share, Market Analysis and Size, Competitive Landscape, Growth Factors, and Trends, and Revenue Forecast
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Key Players Covered in the Report
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Oracle Corp.; Verisk Analytics, Inc.; Parexel International Corp.; Medical Record Associates LLC; Startek Health; Maxim Health Information Services; Aviacode, Inc.; and Precyse Solutions LLC
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United States Medical Coding Market Segment Insights
Outsourced segment to grow at high CAGR
In terms of components, the market is bifurcated into outsourced and in-house. The outsourced segment is estimated to grow at high CAGR during the forecast period owing to the significant rise in the number of healthcare organizations outsourcing their revenue cycle management, including medical coding, to save time and streamline workflow.
Moreover, outsourcing of medical coding services offers a various benefits to the organization, such as minimized claim denials, improved scalability, and reduced operational cost, which is driving the segment growth further.
On the other hand, the in-house segment is anticipated to register significant growth during the projected period attributed to the advantage of retaining control on the entire coding process and in case of any errors, accessing in-house medical coders is easier.
High usage drives the ICD segment
Based on classification systems, the U.S. medical coding market is divided into healthcare common procedure coding system (HCPCS), current procedural terminology (CPT), and international classification of diseases (ICD).
The international classification of diseases segment is anticipated to expand at robust growth rate during the forecast period attributed to the high usage of this codes by healthcare organization.
Furthermore, ICD code has undergone many revisions, which is major driver of the segment. However, the healthcare common procedure coding system segment is projected to expand a considerable CAGR during the forecast period owing to the US government has made the mandatory use of these code under the under the Health Insurance Portability and Accountability Act.
Additionally, the segment growth is further accelerated as HCPCS is used by third-party insurance providers, Medicaid, and Medicare.
Segments
Components
Classification Systems
- Healthcare Common Procedure Coding System
- Current Procedural Terminology
- International Classification Of Diseases
Country
Key Players
- Oracle Corp.
- Verisk Analytics, Inc.
- Parexel International Corp.
- Medical Record Associates LLC
- Startek Health
- Maxim Health Information Services
- Aviacode, Inc.
- Precyse Solutions LLC
Competitive Landscape
Key players competing in the U.S. medical coding market are Oracle Corp.; Verisk Analytics, Inc.; Parexel International Corp.; Medical Record Associates LLC; Startek Health; Maxim Health Information Services; Aviacode, Inc.; and Precyse Solutions LLC.
Companies are focusing on providing technologically advanced medical coding systems for healthcare sector to maintain their competitive position in the market. Companies have been widely engaged in strategic partnership, merger & acquisition, new product launch, and collaborations to boost their market share and acquiring new buyers.
For instance, in February 2020, Verisk Analytics, Inc. a data analytics and risk assessment firm headquartered in New Jersey, collaborated with SCOR, a reinsurance company to launch an Artificial Intelligence based analytical platform for computerized underwriting of life insurances.
In March 2020, the US Department of Health and Human Services includes a federal agency Centers for Medicare & Medicaid Services, which developed a Healthcare Common Procedure Coding System (HCPCS) code for COVID-19 laboratory tests.
With the development of this code laboratories can use the HCPCS code to bill for COVID-19 diagnostic tests as well as the code will help in tracking of new cases and in increasing testing.
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