2026 RPM & CCM Revenue Calculator
Enter your practice size, select your location, and choose your services. We'll project your Year 1 and Year 2 revenue using official 2026 CMS rates for your specific locality.
Year 1: 55% enrollment of eligible patients. Year 2: 34% long-term adherence of Year 1 cohort. 90% payer mix applied. Year 1 includes one-time 99453 setup fees.
Nsight Health achieves 55% Year 1 enrollment vs. the industry average of 20%. Better enrollment means more patients receiving care and higher reimbursement capture.
| CPT | Description | Rate | Patients | Annual Rev |
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- All rates are 2026 CMS PFS Final Rule locality-specific Medicare non-facility reimbursement, effective January 1, 2026.
- Actual reimbursement varies by GPCI, payer contracts, and MAC policies. Commercial and Medicaid payers set independent rates.
- Nsight assumptions: 35% of patients eligible, 55% Year 1 enrollment, 34% long-term adherence, 90% payer mix, avg 2.5 billable 99458 units for 30% of RPM patients, avg 1.89 billable 99439 units per CCM patient. 40% of enrolled patients CCM-eligible, 15% PCM-eligible, 10% BHI-eligible.
- Industry comparison: 20% enrollment rate for both Year 1 and Year 2.
- CMS billing rules enforced: 99453 one-time only. 99458 max 2x/patient/month. 99454/99445 mutually exclusive. 99457/99470 mutually exclusive.
- This calculator is for educational and financial planning purposes only. Not billing, legal, or compliance advice.
Ready to Capture This Revenue?
Nsight Health provides fully managed RPM, CCM, PCM, and BHI programs. Our clinical team handles enrollment, monitoring, and documentation so you capture every eligible dollar.
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2026 CMS PFS Final Rule locality rates. Educational purposes only.
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Remote Care For Your Practice
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Their reliable RPM/CCM services, combined with outstanding customer support, make them a trusted and highly recommended partner in chronic disease management.
Practice Manager
Nsight has been a strong partner to our practice, and I would confidently recommend your services to other clinics looking for effective, clinician-friendly solutions.
MD
I deeply appreciate the great service Nsight has consistently provided to our patients. Your team’s dedication and professionalism have made a real difference, and it’s been a pleasure working with you.
Medical Biller and Coder
Remote Care. At Scale. For Your Patients.
Key CPT codes for remote monitoring include 99453 (setup/education), 99454 (device supply and data transmission), and 99457/99458 (management services) for general remote monitoring. Maximize your current physician group and establish RPM for your healthcare practice.
Turn-Key
Outsource identification, enrollment, onboarding, care coordination, and ongoing adherence.
Pay for Performance
Fee-for-service models include pay for performance to allow reimbursement prior to payment for services.
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Our 24/7 clinical team educates, monitors, assesses and escalates following evidence-based protocols.
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