PCM PROJECTION TOOL
PCM Revenue Estimation Calculator
Precision revenue projection based on your actual service mix and time-tier distribution.
Built for specialty practice managers and billing leads evaluating principal care management economics.
STEP 1 · INPUT PATIENT POPULATION ASSUMPTIONS
Total FFS Medicare Patient Population
Your total fee-for-service Medicare panel size (exclude Medicare Advantage)
% of Patients Eligible for PCM
30%
0%
100%
Patients with at least 1 chronic condition expected to last 3+ months. National Council on Aging (NCOA) estimates 95%.
% of Eligible Patients Enrolled in PCM
50%
0%
100%
Realistic enrollment rate after consent and outreach. Industry average is 40–70%.
STEP 2 - INPUT TIME DISTRIBUTION ASSUMPTIONS
How is your PCM time distributed across enrolled patients?
Enter the tier mix once below and the calculator will apply the same distribution percentages to both provider-delivered and clinical staff-delivered PCM patients.
%
% receiving 30–59 min (applies to both Provider and Clinical Staff)
%
% receiving 60–89 min (applies to both Provider and Clinical Staff)
%
% receiving 90–119 min (applies to both Provider and Clinical Staff)
% receiving 120+ min (auto)
Would you like to add additional care management programs for PCM patients?
Yes
No
Patient Funnel
Revenue Breakdown by Program
Program
Monthly Revenue
Annual Revenue
PCM
TOTAL RECURRING
Estimates based on 2026 CMS national average reimbursement rates. Actual reimbursement varies by geographic locality (GPCI). Calculator does not include initiating-visit reimbursement)