U.S. Medical Coding Market Size, Share & Trends Analysis Report By Classification System (ICD, HCPCS, CPT), By Component, By Medical Specialty, And Segment Forecasts, 2023-2030

The U.S. medical coding market size is estimated to reach USD 38.6 billion by 2030, based on a new report by the publisher. The market is expected to expand at a CAGR of 9.85% from 2023 to 2030. The growth of the market is attributed to the rising number of healthcare centers, such as hospitals, specialty clinics, ambulatory surgical centers, and cancer care centers, which is driving the need for medical coding services. Besides, the high demand for coding by healthcare professionals in the country to update patient records has accelerated market growth. For instance, according to the U.S. Bureau of Labor Statistics (BLS), employment of medical staff, including medical billing and coding specialists, is anticipated to increase to 13% between 2016 and 2026.

Alternatively, increasing focus to minimize fraud and other issues associated with the misinterpretation of medical documents is driving the market. According to the National Health Care Anti-Fraud Association, healthcare fraud cost around tens of billions of dollars every year. Moreover, the rising use of medical coding and billing procedures in RCM is estimated to propel market growth.

Healthcare spending in the U.S. is increasing rapidly. As per the Centers for Medicare & Medicaid Services, healthcare spending in the U.S. is estimated to increase by 5.1% annually between 2021 and 2030. Healthcare spending in the U.S. is estimated to reach USD 6.8 trillion by 2030. Moreover, the administrative costs in healthcare are growing rapidly. Thus, healthcare providers are adopting outsourcing services for revenue cycle management and medical coding to reduce administrative costs. This is propelling the market growth.

Medical coding outsourcing provides benefits such as reduction of billing errors, ensuring billing compliance, and improving patient satisfaction. Multiple revenue cycle management vendors such as R1RCM and Optum are offering complete revenue cycle management solutions including medical coding to reduce the burden on healthcare providers and payers. The COVID-19 pandemic has resulted in the addition of new diagnoses and procedures. Moreover, a shift in telehealth for outpatient care resulted in additional challenges for healthcare providers for billing. Newer codes were introduced for COVID-19 and telehealth. Healthcare providers are facing challenges to meet the changing requirements and are thereby adopting outsourcing services. This in turn is positively impacting market growth.

U.S. Medical Coding Market Report Highlights

• Based on classification system, the ICD segment dominated the market in 2022. The growth can be attributed to frequent revisions in the ICD classification system, leading to an increase in the adoption of coding services, and the introduction of additional codes and inclusion of government mandates
• In terms of component, the outsourced segment accounted for the largest revenue share in 2022 and is projected to expand at the fastest CAGR during the forecast period
• On the basis of medical specialty, the cardiology segment is likely to exhibit the fastest growth owing to complicated procedures which require well-trained coders
• In April 2023, Health Information Associates launched HIAlearn which is an online medical coding education platform for coders and students. It serves as an education shop for coders looking for specific training plans on CPT, ICD-10, and evaluation and management and is accepted by AAPC and AHIMA