ROI & Reimbursement Calculator
Explore illustrative reimbursement and software-cost scenarios. These estimates exclude other delivery costs and are not a quote, guaranteed revenue or practice profit.
$93–$237
Illustrative Revenue / Patient / Mo
$8–$16
Software-Cost Assumptions / Patient / Mo
Model
Not a Pricing Quote
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.
The $8/$12/$16 inputs are modelling assumptions, not published contractual tiers. Confirm current pricing and terms with Positive Check.
Revenue / Software Cost
11.3x
RPM + CCM · 100 patients
Monthly Revenue
$13,515
Monthly Software Cost
$1,200
After Software Cost*
$12,315
*After software cost means revenue minus the assumed software charge only. It is not net profit. Clinical staffing, devices, integration, onboarding and other overhead are excluded. The multiple divides revenue by software cost; it is not a full return-on-investment calculation.
Annual Projections
Revenue
$162,180
Software Cost
$14,400
After Software Cost*
$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 structured responses and surface patients for qualifying clinical-staff follow-up. |
| 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. |
| 99454 | RPM — device(s) supply with daily recordings or alert transmission, each 30 days | $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 outreach supports timely contact workflows and routes patients to clinical staff. |
Understand total cost before deciding
Budget for retained clinical staff, software, devices where relevant, integration, onboarding and ongoing support. Ask for a written quote stating the pricing unit, any minimum commitment, one-time charges and pilot terms. Do not infer those terms from the calculator presets. Request pricing for your workflow or use the implementation checklist to prepare your scope.
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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