Revenue Calculator Assumptions:
30% of total Medicare patients enrolling is based on (i) Medicare Chart Book’s data showing that ~68% of medicare patients qualify for CCM (2 or more chronic conditions), and (ii) that ~40% of eligible patients will enroll.
For typical providers, $14 of net profit per patient per month is based on a Medicare reimbursement of ~$43 per patient per month (national average) for CPT code 99490.
For FQHCs or RHCs, $26 of net profit per patient per month is based on a Medicare reimbursement of ~$67 per patient per month (national average) for G-code G0511.
Other assumptions include average national salary for RN care coaches, 20% overhead, time/costs allocated for minimal management (1hr per week per RN) and non-care coaching tasks per CircleLink historical data.
CPT and other codes, descriptions and other data are copyright 2011 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).