AAFP COVID-19 Related Loss Calculator

The financial modeling provided in this workbook is intended to help you identify the impact of COVID-19 on
expenses for your practice in case you choose to apply for federal funds available to support physician pract
businesses economically harmed by COVID-19.

Information provided by the AAFP is not a suggestion, invitation, direction, or recommendation to modify ma
otherwise engage in any discussion or agreement to: (1) raise, lower, or stabilize prices; (2) regulate produc
markets; (4) encourage boycotts; (5) foster unfair trade practices; or (6) in any other way violate federal or st

Using the Calculator

Along the bottom of the workbook are tabs titled Projected Revenue Inputs, Practice Financials, and Summa
Click on the tab to open the associated worksheet.

Projected Revenue Inputs

The Projected Revenue Inputs worksheet can be used to estimate the number of patients visits and r
month for a selected group of services. The worksheet includes the step-by-step process for inputting
your practice. You will need your top payers and their corresponding fee schedules as well as the pe
covered by each payer to fill out this worksheet. This sheet allows you to estimate the number of enc
for a four-month period (February-May 2020). The worksheet automatically calculates your projected
information you provided for each payer and your estimated visits.
Practice Financials
The Practice Financials worksheet details your practice’s monthly expenses and revenue. The works
enter information based on your 2019 actuals and your 2020 projections. Add your own practice expe
the green-tinted cells. The rows and columns tinted yellow will automatically calculate based on the in
in the Projected Revenue Inputs worksheet.

The items listed are to help guide you in calculating your overall practice expenses and revenue. You
sub-items to better reflect your practice.

You can also input your estimated patient volume to quantify the number of face-to-face visits versus
year-over-year. The information in these rows are estimates and do not auto-populate from other tab

Summary of Financial Impact

The Summary of Financial Impact worksheet is a condensed view of your inputs to the Projected Rev
Practice Financial worksheets. It provides the overall impact of COVID-19 on your practice’s expense
operating income.
 impact of COVID-19 on the revenue and
support physician practices and other small

mendation to modify market conduct or

ces; (2) regulate production; (3) allocate
way violate federal or state antitrust laws.

Financials, and Summary of Financial Impact.

er of patients visits and revenue generated by

step process for inputting the data specific to
edules as well as the percentage of patients
mate the number of encounters you anticipate
alculates your projected revenue using the

and revenue. The worksheet allows you to

d your own practice expenses and revenue in
calculate based on the information you provided

enses and revenue. You can customize the

ace-to-face visits versus telehealth/virtual visits

-populate from other tabs.

puts to the Projected Revenue Inputs and

your practice’s expenses, revenue, and net
 Projected Revenue Inputs

Step 1: Enter the top 3 payers into "Payer Mix" table (includes commercial and Medicare Advantage) - light blue c
Step 2: Enter the percentage of patients covered by each payer listed in the "Payer Mix" table - blue cells Total m
Step 3: Identify allowables for each payer for the listed services - light green cells
Note: The 2020 National Medicare Non-facility Allowables have been autopopulated. However, they may be rep
Step 4: Enter Self-Pay rates - dark green cells
Step 5: Estimate total number of visits for each service - gray cells
All yellow boxes are protected cells as they are calculated from the information you provided in th
The estimated revenue will be automatically moved to your Practice Financials Worksheet.

Payer Mix

[Payer 1] [Payer 2] [Payer 3] [Payer 4]

0% 0% 0% 0%

Office Visit Evaluation and Management (E/M) Services‼

Code Description [Payer 1] [Payer 2] [Payer 3]

99201 New Patient E/M - Level 1
99202 New Patient E/M - Level 2
99203 New Patient E/M - Level 3
99204 New Patient E/M - Level 4
99205 New Patient E/M - Level 5
99211 Established Patient E/M - Level 1
99212 Established Patient E/M - Level 2
99213 Established Patient E/M - Level 3
99214 Established Patient E/M - Level 4
99215 Established Patient E/M - Level 5
‼
Includes E/M services provided via telehealth

Wellness & Care Coordination Services

Code Description [Payer 1] [Payer 2] [Payer 3]

Initial Preventive Physical Examination
G0402 (IPPE)
G0438 Initial Annual Wellness Visit (AWV)
G0439 Subsequent AWV
Chronic Care Management (CCM) by
99490 Clinical Staff (20 minutes)
CCM by Physician or Qualified Health
99491 Professional
 CCM by Clinical Staff (additional 20
G2058 minutes)
99487 Complex CCM (60 minutes)
99489 Each Additional 30 minutes
Advance Care Planning (first 30
99497 minutes)
Advance Care Planning (additional 20
99498 minutes)
Transitional Care Management
99495 (moderate medical complexity)
Transitional Care Management (high
99496 medical complexity)

Virtual Visits/Telephone Visits

Code Description [Payer 1] [Payer 2] [Payer 3]

99421 Online E/M 5-10 minutes
99422 Online E/M 11-20 minutes
99423 Online E/M 21 or more minutes
G2012 Virtual Check-in
Remote evaluation of recorded
G2010 video/images
99441 Telephone E/M 5-10 minutes
99442 Telephone E/M 11-20 minutes
99443 Telephone E/M 21-30 minutes

*Source: Medicare Physician Fee Schedule Look Up

Medicare Advantage) - light blue cells
yer Mix" table - blue cells Total must equal 100.
s
ulated. However, they may be replaced with local rates, if desired.

information you provided in the above steps.

ancials Worksheet.

Payer Mix
Fee-for-Service
Medicaid Medicare Self-Pay Total
0% 100% 0% 100%

Management (E/M) Services‼

2020 National Medicare 2020 February

[Payer 4] Medicaid Non-facility Allowable* Self-Pay Projected Visits
$ 46.56
$ 77.23
$ 109.35
$ 167.09
$ 211.12
$ 23.46
$ 46.19
$ 76.15
$ 110.43
$ 148.33
0

oordination Services

2020 National Medicare 2020 February

[Payer 4] Medicaid Non-facility Allowable* Self-Pay Projected Visits

$ 168.54
$ 172.87
$ 117.29

$ 42.22

$ 84.09
 $ 37.89
$ 92.39
$ 44.75

$ 86.98

$ 76.15

$ 187.67

$ 247.94
0

elephone Visits

2020 National Medicare 2020 February

[Payer 4] Medicaid Non-facility Allowable* Self-Pay Projected Visits
$ 15.52
$ 31.04
$ 50.16
$ 14.80

$ 12.27
$ 14.44
$ 28.15
$ 41.14
0

Total 2020
February Visits

0
 2020 February 2020 March
Estimated 2020 March Estimated 2020 April 2020 April
Revenue Projected Visits Revenue Projected Visits Estimated Revenue
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2020 February 2020 March

Estimated 2020 March Estimated 2020 April 2020 April
Revenue Projected Visits Revenue Projected Visits Estimated Revenue

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2020 February 2020 March

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Revenue Projected Visits Revenue Projected Visits Estimated Revenue
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Total 2020
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February
March Visits March Revenue Visits Revenue
Revenue
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 2020 May 2020 May Estimated
Projected Visits Revenue
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Projected Visits Revenue

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2020 May 2020 May Estimated

Projected Visits Revenue
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Visits Revenue

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 Practice Financials Worksheet

Yellow cells pull in the data provideds from the 'Project Revenue Tab' will appear in the light and dark yellow ce
Enter Monthly Actual Data for 2019 & 2020 Projected Expenses in light and dark green cells
Blue cells calculate the inputs inserted in the green for the section
Grey columns F & L auto-calculate the totals by year
Column N calculates the imact due to Covid from year totals

2019 (Based on Actuals)

Practice Financials by Month Feb March

Revenue
Fee-for-service Office Visit E/M
Virtual Visits/Telephone Visits
Chronic Care Management
Annual Wellness Visits
Transitional Care Management
Advance Care Planning
Per Member Per Month (PMPM)
Lab
Radiology
Procedures
Patient self-payments/copayments
Vaccine and administration fees
Other
Total Revenue $ - $ -

Expenses
Payroll $ - $ -
Physician
Nonphysician provider (NP, PA, etc.)
Clinical Staff (MA, RN, etc.)
Non-Clinical Staff (receptionist, office manger, etc.)
Payroll taxes
Other
Practice Expenses $ - $ -
Rent
Utilities (electricity, water, gas, etc.)
Internet & Phone Costs
EHR/Information Technology
Telehealth Platform
Biohazard waste removal
Custodial services
Other
Supplies & Equipment $ - $ -
Medical
Vaccines
Office Supplies (non-medical)
Write-offs (expired vaccines/medications)
COVID Related Supplies
Donations
Other
Physician Expenses $ - $ -
Loan repayment
Other
Benefits (All Staff) $ - $ -
Health/dental/vision/life insurance
Retirement/401k
Paid/Sick Leave
Other
Insurance (monthly costs/premium payments) $ - $ -
Malpractice
Liability
Property
Worker's compensation
Other
Maintenance and Repairs $ - $ -
Other
Professional Services (if outsourced) $ - $ -
Legal
Accounting
Payroll
Answering services
Billing
Other
Administrative $ - $ -
Credit card/banking fees
Other Loans
Other
Total Expenses $ - $ -

Net Operating Income $ - $ -

2019
Patient Volumes* 0 0
Face to Face Visits
Telehealth
*Input your estimated patient volume to quantify the number of face-to-face visits versus telehealth/virtual visits yea
 n the light and dark yellow cells under 2020 projections
green cells

9 (Based on Actuals) 2020 (Projection

2019
April May Feb
Totals

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2019 Totals 2020

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0
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s telehealth/virtual visits year-over-year. The information in these rows are estimates and do not auto-populate from other tabs
 2020 (Projections)
2020
March April May
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nd do not auto-populate from other tabs.
 Impact Due to
COVID

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 Summary of Financial Impact
*All numbers are pulled from the 'Practice Financials'' worksheet

2019 (Based on Actuals)

Feb March April

Total Revenue $ - $ - $ -

Total Expenses $ - $ - $ -

Net Operating Income $ - $ - $ -

Patient Volumes 0 0 0
uals) 2020 (Projections)
2019
May Feb March April
Totals

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s)
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May
Totals COVID

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