CHRONIC CARE MANAGEMENT

Revenue Calculator

The Revenue Calculator enables you to project the incremental impact of Medicare’s CCM program on your practice billings. By providing your practice data (or reasonable estimates) in the shaded cells, you will be able to model the financial opportunity associated with chronic care management.

CCM Revenue Source* Benchmark Your Practice
Annual number of unique patients per MD 1 2,300
Percent of patients covered by Medicare 2 21.9%
Annual number of unique Medicare patients 503
Percent with 2+ chronic conditions 3 68.6%
Annual number of unique CCM patients 345
Patient opt-in rate 4 10%
CCM monthly payment 5 $43.12 43.12
Months billed per patient per year 6 6
Estimated revenue per MD $8,919
Total MDs in practice 8
Estimated revenue per practice $71,355

1. "Physicians in retainer (“concierge”) practice. A national survey of physician, patient, and practice characteristics," Alexander, Kurlander, Wynia. Journal of General Internal Medicine, 2005.

2. MGMA Cost Survey For Single Specialty Practices, 2013. Data specific to specialty of family medicine. Includes Medicare A/B and Medicare Advantage.

3. CMS.gov – County Level Multiple Chronic Conditions (MCC) Table: 2012 Prevalence, National Average

4. "The National Chronic Care Management Survey 2015" - PYA Consultants and Enli Health Intelligence.

5. Reimbursement amount from the CY 2015 Physician Fee Schedule Final Rule.

6. "The National Chronic Care Mangement Survey 2015" - PYA Consultants and Enli Health Intelligence.