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  • #31
    Sorry, meant $46 per wRVU in Phoenix for FM

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    • #32





      Click to expand…






      According to my hospital, MGMA median for psychiatry is $37.   I am paid ~$50 in the rural south though I also have non-productivity compensation.

       

      Also found this but no clue if accurate:

      https://www.statista.com/statistics/293878/compensation-per-rvu-of-us-physicians-by-specialty/
      Click to expand…


      I would question your hospital’s data.  I routinely hear $60-65 per wRVU in psych as the going rate.

      The below data lists the median salary by specialty and annual wRVU.  You can easily extrapolate the average compensation per wRVU, and for psychiatry, that turns out to be around $62.  I am in the $65 range in a rural western town.  None of these major surveys, for the record, include benefits in these calculations.

      http://www.beckershospitalreview.com/compensation-issues/2015-physician-compensation-work-rvu-by-specialty.html
      Click to expand...


      I quite dont get the calculation of $/RVU. For the example in psychiatry the beckerhospitalreview the  link says

      Compensation: $254,942
      wRVU: 4,079

      254,942/4709= 54.13. How the   $62 is calculated  from that data?

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      • #33


        1. hypercube wrote:




        I quite dont get the calculation of $/RVU. For the example in psychiatry the beckerhospitalreview the  link says

        Compensation: $254,942
        wRVU: 4,079

        254,942/4709= 54.13. How the   $62 is calculated  from that data?
        Click to expand...


        It's 254,942/4079 = 62.5. You transposed the 0 and 7 in 4079.

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        • #34
          Invasive non-interventional cardiology, in the upper midwest, small-mid size town (MSA population ~250k).

          We have a tier system:

          Tier 1 ~45$/wRVU (if total RVUs <4000/yr)

          Tier 2 ~66$/wRVU (if total wRVUs between 4000-8500)

          Tier 3 ~85$/wRVU (for RVUs exceeding 8500 RVU)

          The total RVUs needed to get into Tier 3 has been increasing every year (used to be 7800 a year ago).

          How do the hospitals determine what $ amount to assign a wRVU for a speciality?

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          • #35
            They take the lowest rvu number possible to adequately recruit and retain that specialty..

            Ultimately our system justifies the number by averaging the median number of three national surveys.

            Knowledge is helpful from the docs side. Wish more would discuss contracts within their region.

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            • #36
              we use large clinic survey to determine our rvu multiplier.  we use the median number nationally per sub subspecialty whenever available.

              we have access to the regional numbers as well as mgma and amga.

               

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              • #37
                $61 per rvu in psychiatry in Mountain West, increasing to $65 next year.

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                • #38
                  70.20 for urology in Midwest

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                  • #39
                    Hospitalist in the midwest.  Not sure if this is how you calculate the "RVU index" but, my group pays a base salary of 240k for 1 FTE and there's a 4000 wRVU/yr minimum that must be met.  That equates to about $60 per wRVU.  There's a productivity bonus that doesn't kick in until 4400 wRVUs (which is BS) and any RVUs over 4400 get paid at $26/RVU.

                    I have for a long time felt that the productivity bonus system was terrible for our group because of this.  If you make up to 4399/yr, you get no productivity bonus.  Plus, 26/rvu over the threshold seems low to me.

                    Does anyone else ever wonder if the whole RVU system is a major conflict of interest?  Docs in my group submit their own charges everyday.  It seems like it would be really easy to be accused of over billing in order to get a bonus each quarter.  I really don't like this system personally.  I think a 3rd party should be submitting our charges based on our documentations.  That way we can't get accused of trying to scam the system.

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                    • #40
                      Historically they come after docs for Medicare fraud so no docs would ever want someone else to change their billing unless the risk went away with it.

                      They monitor things for both over billing and underbilling. Underbilling results in clustering where the patterns done match up with similar hospitals and was construed by Medicare as an incentive to encourage patients to go to certain hospitals for care. That’s a no no from Medicare perspective. Can’t underbill Medicare patients. Can’t treat them without billing for services rendered. Can’t overbill them obviously.
                      Docs can’t win for losing.

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                      • #41
                        Well that sucks.  I had never thought about the under-billing thing.  I always figured it would be better to under-bill.  Damn it!

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                        • #42




                          Well that sucks.  I had never thought about the under-billing thing.  I always figured it would be better to under-bill.  Damn it!
                          Click to expand...


                          You shouldn't underbill or overbill.  But if you err on one side ... well... I don't know of any docs serving time for underbilling.  RACS hired-gun auditors are paid based on the amount they recover.  They don't have an incentive to go after underbilling doctors - there is no fee to recover for them.

                           

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                          • #43







                            Well that sucks.  I had never thought about the under-billing thing.  I always figured it would be better to under-bill.  Damn it!
                            Click to expand…


                            You shouldn’t underbill or overbill.  But if you err on one side … well… I don’t know of any docs serving time for underbilling.  RACS hired-gun auditors are paid based on the amount they recover.  They don’t have an incentive to go after underbilling doctors – there is no fee to recover for them.


                            Last I checked the ratio was something like 60:1 Medicare fraud charges overbilling: underbilling. So if I happen to make an honest mistake it will be on the underbilling side.

                             

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                            • #44


                              any RVUs over 4400 get paid at $26/RVU.
                              Click to expand...


                              It's like they don't want you to generate more than 4400 RVUs...

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                              • #45




                                This is the dollar amount a physician is paid per work RVU (wRVU). A contract may look fantastic because it has a salary of $525,000 but if the wRVU target is 12,000, you will never make that salary. The RVU index is a simple way of comparing contracts and essentially determines how hard you are going to work.
                                Click to expand...


                                I’m in my final year of an ortho residency in the Southeast. Will be doing a fellowship next year, however I am interested in this topic as I agree it is easy to be distracted by the large guaranteed salary.

                                 

                                Interesting, one of my attendings at our academic center netted just over 22,000 RVUs this past year. Unfortunately, this is not by choice as we are understaffed.

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