ROI & Reimbursement Calculator
See how Positive Check turns a low per-patient cost into significant Medicare reimbursement revenue for your practice.
$93–$237
Revenue / Patient / Mo
$8–$16
PC Cost / Patient / Mo
5–15x
Typical ROI Multiple
2026
Medicare Rates
Calculate Your ROI
Adjust the inputs below to see projected revenue, cost, and return based on your patient population and program mix.
Return on Investment
11.3x
RPM + CCM · 100 patients
Monthly Revenue
$13,515
Monthly Cost
$1,200
Monthly Net
$12,315
Annual Projections
Revenue
$162,180
Cost
$14,400
Net
$147,780
Billing Breakdown
How your selected program translates into reimbursable CPT codes.
| CPT Code | Patients | Rate | Compliance | Monthly Subtotal |
|---|---|---|---|---|
| 99457 | 100 | $52 | 85% | $4,420 |
| 99458 | 100 | $41 | 85% | $3,485 |
| 99490 | 100 | $66 | 85% | $5,610 |
| Total Monthly Revenue | $13,515 | |||
Revenue Scenarios
Compare common program configurations. Click “Try This Scenario” to load the values into the calculator.
100 patients · 85% compliance · $12/pt
100 patients · 85% compliance · $12/pt
100 patients · 85% compliance · $12/pt
CPT Code Reference
2026 Medicare national average reimbursement rates and how Positive Check supports each code.
| Code | Description | 2026 Rate | How PC Supports |
|---|---|---|---|
| 99457 | RPM — first 20 min clinical staff time per month | $52 | Automated daily calls collect vitals, symptoms, and wellness data — satisfying the interactive communication requirement. |
| 99458 | RPM — each additional 20 min clinical staff time per month | $41 | Structured call summaries and trend reports reduce clinical review time, making the additional 20 minutes highly productive. |
| 99470 | RPM — device supply & data transmission (practice expense) | $56 | Positive Check serves as the patient-facing data collection layer, transmitting structured responses to the provider dashboard. |
| 99490 | CCM — first 20 min non-complex chronic care management | $66 | Daily wellness calls provide documented patient touchpoints, medication adherence checks, and care plan follow-up. |
| 99439 | CCM — each additional 20 min non-complex CCM | $48 | Automated follow-ups and alert-triggered callbacks generate additional documented care coordination time. |
| 99487 | Complex CCM — first 60 min for patients with multiple chronic conditions | $144 | Daily monitoring with escalation protocols supports the higher documentation bar for complex patients. |
| 99495 | TCM — post-discharge follow-up contact within 2 business days | $178 | Automated post-discharge calls within 24-48 hours satisfy the initial patient contact requirement. |
Important Disclaimers
Estimates are based on 2026 Medicare national average reimbursement rates. Actual reimbursement varies by geographic region (GPCI adjustments), payer mix, and individual claim adjudication. These projections are illustrative and should not be interpreted as guaranteed revenue.
Positive Check supports patient engagement and documentation requirements for Remote Patient Monitoring (RPM), Chronic Care Management (CCM), and Transitional Care Management (TCM) billing. Providers remain responsible for meeting all CMS eligibility criteria, clinical oversight requirements, and proper code selection.
This calculator does not constitute billing, legal, or financial advice. Healthcare organizations should consult with qualified billing professionals, compliance officers, and legal counsel before implementing reimbursement strategies.
CPT is a registered trademark of the American Medical Association. CPT codes and descriptions are used here for informational purposes in accordance with fair use.
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