Quarterly benchmark · 2026-04-15Overview
This benchmark report measures first-pass clean-claim rate across 35 medical specialties using a consistent methodology, drawing on the MGMA specialty benchmark dataset and supplemented with anonymized observations from Medonix's founding client cohort across the trailing twelve months.
Specialty median ranges from 91.8% (substance-abuse rehab) to 98.4% (radiology). The headline insight is that specialty difficulty does not explain the variance: distribution width within each specialty exceeds the variance between specialties for 24 of the 35.
In other words: a poorly-run cardiology practice underperforms a well-run cardiology practice by more than well-run cardiology underperforms well-run radiology. Operational quality dominates structural difficulty across the cohort.
Key findings
- ✓Highest median clean-claim rate: radiology (98.4%), pathology (98.1%), anesthesiology (97.9%).
- ✓Lowest median clean-claim rate: substance-abuse rehab (91.8%), behavioral health (93.2%), wound care (94.1%).
- ✓Widest distribution: pain management (8.9-point spread), behavioral health (7.6), substance-abuse rehab (7.1).
- ✓Tightest distribution: radiology (1.8-point spread), pathology (2.0), anesthesiology (2.4).
- ✓Top denial reason varies by specialty: CO-16 dominant in primary care, CO-197 dominant in procedural specialties, CO-50 dominant in behavioral health.
What is in the report
- Median and 75th-percentile clean-claim rate per specialty
- Specialties with the widest distribution
- Top three denial reasons per specialty
- Payer-mix sensitivity by specialty
- Implications for vendor selection
Methodology
Industry benchmarks sourced from the MGMA Specialty Performance Benchmarks. Cohort observations drawn from Medonix's founding client cohort, trailing twelve months ending March 31, 2026. Specialty assignment based on rendering provider primary taxonomy; multi-specialty groups attributed at the provider level, not the group level. Industry and cohort figures reported separately. Full methodology in the Medonix RCM Methodology Paper, 2026 Edition.
Citation: Medonix Research, "Clean-Claim Rate Benchmarks Across 35 Specialties," 2026.