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CCM/PCM Revenue Calculator
Estimate monthly and annual CCM and PCM revenue with 2026 Medicare rates for any payment locality in the United States.
Pick your state and locality, then enter patients. Totals update as you type.
Estimated Medicare-allowed amount
$0per month
$0 per year
National average
The same month elsewhere
Medicare-allowed, non-facility, CY2026 amounts. Includes the patient’s 20% coinsurance; before the Part B deductible and sequestration. An illustration, not a quote.
The national rates behind the estimate
2026 national, participating, non-facility amounts. Your locality moves each one up or down.
| Code | Service | National 2026 |
|---|---|---|
| 99490 | CCM, clinical staff, first 20 minutes | $66.13 |
| 99439 | CCM, each additional 20 minutes | $50.44 |
| 99487 | Complex CCM, first 60 minutes | $144.29 |
| 99489 | Complex CCM, each additional 30 minutes | $78.16 |
| 99426 | PCM, clinical staff, first 30 minutes | $67.80 |
| 99427 | PCM, each additional 30 minutes | $54.11 |
| G0556 | APCM level 1 | $16.37 |
| G0557 | APCM level 2 | $53.78 |
| G0558 | APCM level 3 | $117.24 |
| G0023 | PIN, first 60 minutes | $87.18 |
| G0024 | PIN, each additional 30 minutes | $54.44 |
| G0019 | CHI, first 60 minutes | $86.17 |
| G0022 | CHI, each additional 30 minutes | $54.11 |
Medicare has 109 payment localities. Most states are one statewide locality; California has 29, Texas 8 and New York 5. For CPT 99490, the 2026 amount runs from $60.71 in Arkansas to $83.76 in Alaska.
How the calculator works
Four rules turn your patient count into a monthly amount.
Your locality sets the rate
Three 2026 GPCIs for your Medicare payment locality adjust each code’s work, practice expense and malpractice value.
Patients times codes
Each patient-month that meets a code’s time rule counts once. Add-on units are counted separately.
Allowed amount, not net
Totals include the patient’s 20% coinsurance and come before the Part B deductible.
Participation status
Non-participating practices are paid 95% of the participating amount.
What the estimate leaves out
Read these before you plan around the number.
Short months earn nothing
Months where a patient falls short of 20 minutes earn nothing under 99490.
One CCM type per month
Regular and complex CCM cannot be billed for the same patient in the same month.
APCM replaces CCM
APCM replaces CCM for a patient-month billed by the same practitioner.
Unpaid patient share
Unpaid coinsurance and deductibles lower what you collect.
Your delivery cost
Your cost to run the program is not part of this estimate.
Computed, not quoted
Amounts are computed from CMS files. Your Medicare contractor’s fee schedule lookup is final.
Questions about CCM and PCM revenue
How much does Medicare pay for CCM in 2026?
For CPT 99490, the 2026 national non-facility amount is $66.13. By locality it runs from $60.71 in Arkansas to $83.76 in Alaska. PCM code 99426 is $67.80 nationally.
Which Medicare locality is my practice in?
Most states are a single statewide locality. Larger states split by county: California has 29 localities, Texas 8 and New York 5. Pick your state and the calculator lists each locality with its counties.
Does the estimate include the patient’s share?
Yes. Allowed amounts include the 20% coinsurance. Medicare pays the rest once the Part B deductible is met.
Can 99439 be billed with 99490?
Yes. 99439 is an add-on for each additional 20 minutes of clinical staff time in the same calendar month.
Can CCM and PCM be billed for the same patient?
Yes, by different practitioners in the same month, as long as no time is counted twice. One practitioner cannot bill both for the same patient in the same month.
Can PIN or CHI be billed with CCM?
Yes, if time and effort are not counted twice. CMS allows CHI and PIN alongside other care management.
Are these amounts guaranteed?
No. They are 2026 fee schedule amounts. Payment depends on participation, place of service, cost-sharing and each claim.
Rates & disclosures
Amounts are 2026 Medicare Physician Fee Schedule non-facility payments: (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × $33.4009, the non-QP conversion factor. Your Medicare contractor’s fee schedule lookup is final. Actual payment depends on participation status, place of service and cost-sharing.
Companian supplies Care Advocates and documentation to physician practices nationwide. Companian is not a medical practice and does not bill Medicare. The billing practitioner keeps the care plan, every clinical decision and the claim. Patients pay the usual Medicare Part B deductible and coinsurance for these services unless other coverage pays it.
Turn the estimate into a monthly program
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