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Calcimator

Telehealth Visit Revenue Calculator

Revenue comparison: telehealth vs in-person visits.

About this calculator

Monthly gross revenue is driven overwhelmingly by monthly telehealth visit count — it is by far the most influential input, since every other factor only adjusts the rate applied per visit while visit count sets the base multiplier for the whole figure. Payer mix shifts the weighted reimbursement rate rather than the visit count: commercial payer mix pulls the average up because the model applies roughly 105% of the Medicare base rate to commercial claims, while Medicaid pulls it down since Medicaid is modeled at about 72% of Medicare. The calculator derives its base Medicare rates from a fixed table indexed by visit complexity (1 through 5, corresponding to E/M levels 99211-99215), and self-pay is treated as whatever percentage remains after Medicare, commercial, and Medicaid are subtracted from 100, floored so it can't go negative.

Collection rate has no effect on monthly gross revenue at all — gross revenue represents billed charges before any collection shortfall, and collection rate only steps in downstream to compute Annual Net Collections, so a practice with excellent billed revenue but a weak collection rate will show strong gross figures alongside a much smaller net-collections number. Left out of this model entirely: a single flat 15% volume-uplift assumption stands in for telehealth's convenience effect on visit demand rather than a modeled response to lower or higher visit volumes, and state-by-state telehealth parity law variation is not represented even though payer telehealth parity is known to differ by state.

Inputs

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Results

Monthly Gross Revenue ($)

$26,579.00

Annual Gross Revenue ($)

$318,946.00

Annual Net Collections ($)$302,998.00
Weighted Avg Reimbursement ($)$88.60
Revenue per Provider Hour ($)$265.79
Volume Uplift Revenue ($/month)$3,987.00
In Person Premium$93.03
How to Use This Calculator
  1. Enter the total number of telehealth visits per month.
  2. Set the payer mix percentages for Medicare, commercial insurance, and Medicaid — any remainder is treated as self-pay.
  3. Choose the average visit complexity (1-5, corresponding to E/M levels 99211-99215) and your expected collection rate.
  4. Review the Monthly and Annual Gross Revenue, along with the Weighted Avg Reimbursement per visit based on your payer mix.
  5. Use the Revenue per Provider Hour and Volume Uplift Revenue outputs to gauge telehealth productivity and the added revenue from higher visit volume.

How the result changes with Monthly Telehealth Visits

Monthly Telehealth VisitsMonthly Gross Revenue ($)Annual Gross Revenue ($)
150$13,289.00$159,473.00
225$19,934.00$239,209.00
450$39,868.00$478,418.00
750$66,447.00$797,364.00

What each input means

Monthly Telehealth Visits
Number of telehealth patient visits per month.
Medicare Payer Mix (%)
Percentage of telehealth visits billed to Medicare.
Commercial Payer Mix (%)
Percentage billed to commercial insurance (BCBS, Aetna, UHC, etc.).
Medicaid Payer Mix (%)
Percentage billed to Medicaid (remainder is self-pay).
Avg Visit Complexity (1-5)
Average E/M level: 1=99211 (minimal), 3=99213 (moderate), 5=99215 (high complexity).
Collection Rate (%)
Percentage of billed charges actually collected. Industry average is 93-97%.

What each result means

Monthly Gross Revenue ($)
Total billed revenue from telehealth visits per month.
Annual Gross Revenue ($)
Projected yearly telehealth gross revenue.
Annual Net Collections ($)
Expected collections after applying collection rate.
Weighted Avg Reimbursement ($)
Average reimbursement per visit based on your payer mix.
Revenue per Provider Hour ($)
Estimated hourly revenue assuming 3 telehealth visits/hour.
Volume Uplift Revenue ($/month)
Estimated additional monthly revenue from ~15% higher visit volume via telehealth convenience.

How this is calculated

Worked example, using the default values

  1. Identify Input Parameters
    4 parameters
    Monthly Telehealth Visits = 300, Medicare Payer Mix (%) = 35, Commercial Payer Mix (%) = 40, Medicaid Payer Mix (%) = 15 = 6 input(s) provided
  2. Calculate Monthly Gross Revenue
    Monthly Gross Revenue = monthlyTelehealthVisits * weightedRate
    26579 = $26,579
  3. Calculate Annual Gross Revenue
    Annual Gross Revenue = monthlyGross * 12
    318946 = $318,946
  4. Calculate Annual Net Collections
    Annual Net Collections = monthlyNet * 12
    302998 = $302,998
  5. Calculate Weighted Avg Reimbursement
    Weighted Avg Reimbursement = (medicarePct / 100) * medicareRate +
    88.6 = $88.6

Engine last updated . Checked against 2 independently-derived tests — how we verify calculators. Built by Paul Gunder, a software engineer, not a licensed financial, medical, or legal professional.

Frequently Asked Questions

What single input matters most to telehealth revenue?

Monthly telehealth visits, by a wide margin. Every other input — payer mix percentages, visit complexity, collection rate — only adjusts the reimbursement rate applied per visit, while visit count is the direct multiplier on the whole revenue figure. Doubling visit volume roughly doubles monthly and annual gross revenue; shifting payer mix percentages produces much smaller proportional changes because it only reweights the blended rate within a narrower band between the Medicaid and commercial rate extremes.

Does a better collection rate increase billed revenue, or just what gets collected?

Only what gets collected. Monthly Gross Revenue and Annual Gross Revenue represent billed charges based on your visit volume and weighted reimbursement rate, calculated independently of collection rate. Collection rate only enters the Annual Net Collections calculation, applying your entered percentage against the gross figure — so improving collection rate raises net collections without changing what the calculator reports as gross revenue.

How does shifting from Medicaid to commercial payer mix change the weighted reimbursement?

The model rates commercial claims at roughly 105% of the Medicare base rate and Medicaid claims at roughly 72% of that same base rate — a real spread of about 33 percentage points between the two. Shifting a percentage of your payer mix from Medicaid to commercial raises the weighted average reimbursement toward the commercial rate, which is the highest of the payer categories modeled here, ahead of Medicare and well ahead of Medicaid.

What does the Volume Uplift Revenue output represent?

It applies a fixed assumption that telehealth generates roughly 15% more visit volume than an equivalent in-person practice would, due to the convenience of not requiring travel or time off work, and multiplies that additional volume by the weighted reimbursement rate. This is a single flat assumption built into the model rather than a rate the calculator derives from your specific inputs, so it should be read as an illustrative estimate of telehealth's potential volume benefit rather than a measured prediction for your specific patient population.

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