Independent guidance on the services practices actually buy. The full provider directory sits behind every topic.
Paneling, payer enrollment, CAQH, timelines, vendor selection.
In-house vs outsource, pricing models, coding, payer contracts.
EHR selection by specialty, migration, practice-management software.
Starting a practice, consultants, MSOs, vetting and costs.
HIPAA rules, malpractice coverage, healthcare counsel, verified vendors.
What 76,965 vendor listings, a 4,337-vendor verified-live subset of the 4,426-vendor graded segment, and a measured dead-site rate say about the market that sells to independent medical and dental practices. Every figure traces to a named query in the methodology appendix.
The full GPH directory holds 76,965 vendor listings across 25 service categories. Inside it sits a graded Tier-1 segment: 4,426 vendors that passed curation grading (2,689 grade A, 1,737 grade B). This report's census counts only vendors whose websites could be verified live as of June 2026: 4,337 vendors (2,688 A, 1,649 B). Of the 89 graded vendors excluded, 22 were verified inactive; the remaining 67 could not be independently verified and are excluded under the verifiable-live rule. Only the verified-inactive count toward attrition.
Size structure of the graded universe (GPH-estimated bands; coverage 100%):
Graded Tier-1 vendors with verified-live sites only (n=4,337 of 4,426 graded). GPH-estimated size bands. Source: query Q-C1.
By vertical (16 categories shown; two categories totaling 3 vendors are rolled into the methodology notes):
| Category | Vendors | A / B | <10 emp | 250+ emp | Median founded | Multi-location |
|---|---|---|---|---|---|---|
| Medical Billing & RCM | 2,448 | 1,532 / 916 | 48.6% | 7.6% | 2015 | 25.1% |
| Healthcare Staffing & Recruiting | 409 | 209 / 200 | 5.4% | 82.6% | 1988 | 42.0% |
| Credentialing Services | 284 | 177 / 107 | 60.2% | 5.6% | 2016 | 30.3% |
| Medical Coding Services | 185 | 131 / 54 | 41.1% | 10.8% | 2014 | 27.2% |
| Patient Financing & Payment Solutions | 152 | 100 / 52 | 16.4% | 46.1% | 2001 | 28.9% |
| Healthcare IT & EHR | 151 | 114 / 37 | 10.6% | 46.4% | 2003 | 39.1% |
| Practice Management Consulting | 114 | 88 / 26 | 29.8% | 18.4% | 2006 | 27.9% |
| Medical Equipment & Supplies | 104 | 60 / 44 | 22.1% | 52.9% | 2001 | 49.0% |
| Practice Financing & Loans | 94 | 37 / 57 | 4.3% | 73.4% | 1984 | 44.7% |
| Compliance & HIPAA Services | 87 | 52 / 35 | 19.5% | 34.5% | 2003 | 46.5% |
| Healthcare Marketing & Reputation Mgmt | 76 | 46 / 30 | 26.3% | 15.8% | 2012 | 30.8% |
| Medical Transcription & Documentation | 74 | 49 / 25 | 32.4% | 31.1% | 2000 | 28.8% |
| Healthcare PR & Communications | 58 | 36 / 22 | 15.5% | 17.2% | 2002 | 43.1% |
| Medical Waste & Environmental Services | 50 | 27 / 23 | 46.0% | 30.0% | 2004 | 50.0% |
| Telehealth & Virtual Care Infrastructure | 29 | 19 / 10 | 13.8% | 41.4% | 2007 | 48.0% |
| Practice Valuation & Brokerage | 19 | 10 / 9 | 10.5% | 36.8% | 2002 | 42.1% |
| All verified-live graded vendors | 4,337 | 2,688 / 1,649 | 38.3% | 22.0% | 2011 | 30.2% |
Live graded vendors only. Size bands GPH-estimated, coverage 100%. Median founded computed on known years (84.4% coverage). Multi-location share computed on location-known vendors (97.4% coverage). Source: queries Q-C1, Q-C2.
Medical Billing & RCM is the largest graded vertical by a factor of six -- 2,448 live vendors -- and the most fragmented of the large ones. Nearly half (48.6%) have fewer than 10 employees. The median firm has 10 people. The age structure says this is not a legacy market thinning out; it is a market still being entered:
Graded billing/RCM vendors with known founding years (n=1,973 of 2,448). Source: query Q-C2.
For anyone evaluating this vertical as a consolidation target, the long tail is the story: 1,190 live, graded sub-10-employee billing firms, with another 770 in the 10-to-49 band. The fragmentation is national, not regional -- in every state with 30 or more graded billing vendors, the sub-10 share runs between 31% and 68%.
| State | Graded vendors | <10 emp share | Headcount HHI |
|---|---|---|---|
| California | 264 | 43.2% | 1,210 |
| Texas | 230 | 50.0% | 1,035 |
| Florida | 224 | 48.2% | 889 |
| New York | 134 | 44.0% | 462 |
| New Jersey | 88 | 45.5% | 2,507 |
| Illinois | 83 | 49.4% | 6,324 |
| Georgia | 71 | 49.3% | 6,948 |
| Pennsylvania | 68 | 50.0% | 2,416 |
| Ohio | 63 | 52.4% | 1,189 |
| Maryland | 40 | 67.5% | 8,958 |
| Virginia | 40 | 55.0% | 2,383 |
| North Carolina | 39 | 46.2% | 3,784 |
| Colorado | 38 | 63.2% | 967 |
| Tennessee | 38 | 31.6% | 1,596 |
| Arizona | 37 | 67.6% | 1,917 |
| Massachusetts | 36 | 36.1% | 7,568 |
| Missouri | 35 | 60.0% | 9,293 |
| Michigan | 33 | 63.6% | 4,141 |
| Indiana | 32 | 56.2% | 1,214 |
| Washington | 32 | 50.0% | 2,119 |
| 24 states with fewer than 30 vendors | 211 | 47.9% | -- |
Live graded billing/RCM vendors with state attribution. Headcount HHI is a concentration proxy built on employee-count shares, not revenue; it is inflated where one large employer sits in a small state cell. Source: query Q-R1.
With headcount as the share proxy (revenue shares are not observable at this scale), the graded verticals split into three regimes. Fragmented: billing/RCM (HHI 2,109 driven by a handful of national firms over a vast tail), coding (1,362), marketing (937). Anchored: staffing (151 -- big firms, but many of them), patient financing (302), IT/EHR (433). Concentrated: practice management consulting (4,858) and telehealth infrastructure (5,059), where one or two large employers dominate the graded set. Billing/RCM's headcount HHI reads concentrated only because a few national employers dominate headcount; by vendor count it is the most fragmented large vertical in the set -- 2,448 firms, half under 10 people.
The consolidatable tail, sized: across all graded verticals, 1,660 live vendors have fewer than 10 employees -- 38.3% of the graded universe. 1,190 of them are in billing/RCM alone.
Headcount-share HHI = 10000 x sum of squared employee-count shares per category. A proxy, labeled as such everywhere it appears. Source: query Q-C1 (sums), definition in methodology.
For readers who use the antitrust convention: the DOJ and FTC 2023 Merger Guidelines (issued December 18, 2023) treat a market with an HHI above 1,800 as highly concentrated. On that threshold three graded verticals read as highly concentrated on headcount share (billing/RCM at 2,109, practice management consulting at 4,858, telehealth infrastructure at 5,059), and the "fragmented" label this report gives billing/RCM is a vendor-count judgment rather than an HHI one. The two readings measure different things, and each figure above says which one it uses. A practice choosing among the 2,448 graded billing firms can start with how to choose a medical billing company and score the shortlist on the RCM vendor evaluation scorecard.
GPH probed the websites of 6,295 vendors in the directory's commercial core. 536 -- 8.5%, about 1 in 12 -- were dead: domain gone or site permanently down. A manual audit of a stratified sample of those dead classifications measured a 5% false-positive rate (n=75), which holds the dead-site rate in an 8.1-8.5% band. A further 6.7% could not be independently verified and are excluded from the churn figure.
Hard-dead rate (dead_site only) among probed domains, categories with 100+ probes. Domains that could not be independently verified are excluded rather than counted as attrition. Source: query Q-CH1.
The pattern matches the size structure: the verticals with the longest small-firm tails churn hardest. Billing/RCM -- youngest, smallest -- loses members at 15 times the rate of staffing and recruiting (12.1% vs 0.8%). Inside the graded set the pattern repeats: of the 22 graded vendors verified dead at probe time, 21 were grade B.
For a practice, a vendor in the 12.1 percent is a continuity problem before it is a selection problem. Switching billing companies without a cash-flow gap covers the handoff, and the first 90 days with an outsourced biller covers what the replacement relationship should look like once it starts.
Across the full live directory (76,009 listings; 96.9% carry a state attribution), supply concentrates where practices concentrate -- Texas (3,039), California (2,909), Florida (2,733), New York (2,366) -- but the floor is high everywhere: 41 states have at least 1,000 live listings. Billing/RCM supply is far more top-heavy than the directory overall: Texas (632), California (570), and Florida (486) hold 34% of state-attributed billing listings between them, against the same three states' 12% share of the directory as a whole.
Live directory listings with state attribution (73,669 listings; 96.9% of the live directory). Source: query Q-G1.
An outside check on the geography: the Bureau of Labor Statistics Quarterly Census of Employment and Wages counts 241,322 private offices of physicians (NAICS 6211) nationally in the first quarter of 2025, led by California (36,679), Texas (25,996), Florida (23,462) and New York (14,861), per the QCEW 2025 Q1 industry file for NAICS 6211. The same four states lead the GPH directory, with Texas and California in the opposite order; the directory counts vendors and QCEW counts the practices they sell to, so the two rankings agree on the set and not on the sequence.
Of 126 practices that used GetPracticeHelp's vendor-matching tool between April 14 and June 11, 2026, 67% (85) were seeking billing or RCM help. This is an early-stage sample and we report it with its size attached. Nothing below category level clears this report's minimum cell size of n>=10, so nothing below category level is reported.
One reading, offered with that caveat: the vertical where practices most often ask for help is also the vertical with the most fragmented supply and the highest vendor attrition. If that demand pattern holds as the sample grows, the billing/RCM long tail is not just a consolidation story; it is a selection-burden story for the practices doing the choosing.
For the practices on the demand side of that pattern, the selection work starts with the outsource-versus-in-house decision and, for those that outsource, the questions to ask a billing company before signing. Practices whose ask is credentialing rather than billing can start with the ranked credentialing companies.
All supply-side figures derive from the GetPracticeHelp vendor directory as of June 11, 2026: 76,965 listings across 25 service categories, with a graded Tier-1 segment of 4,426 vendors, per-field provenance, third-party firmographic enrichment on 23,502 listings, and website-liveness probes on the 6,295-listing commercial core. The directory and its grading are described at /data-licensing/.
Every published figure traces to one of the queries below, run read-only against the production directory database on June 11, 2026.
Canonical URL: https://www.getpracticehelp.com/research/state-of-independent-practice-vendors-2026/
GetPracticeHelp Research, "The State of Independent Practice Vendors 2026," June 2026. Data as of June 11, 2026. https://www.getpracticehelp.com/research/state-of-independent-practice-vendors-2026/
Journalists and analysts: the underlying aggregates and methodology notes are available on request, and the dataset behind the report is documented at /data-licensing/. A PDF edition is available here.