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Supervising midlevels as only income..

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  • Supervising midlevels as only income..

    Psychiatrist in town no longer seeing patients and instead has 7 midlevels....busy clinic. What do u think he takes home? Owns his own Private practice


  • #2
    I have no knowledge about billing in Psychiatry but I'd wager he's taking home at least what he's paying them.

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    • #3
      Whatever it is, it’s a low price for selling one’s dignity.
      “Work” is a four letter word for good reason.

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      • #4
        Originally posted by Lithium View Post
        Whatever it is, it’s a low price for selling one’s dignity.
        You sure about that? I'm sure we can find people who routinely sell it for even less. Sadly, dignity isn't a very highly valued commodity.

        I'd be surprised if he wasn't being paid well above market for his dignity.

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        • #5
          $2M

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          • #6
            Originally posted by AR View Post

            You sure about that? I'm sure we can find people who routinely sell it for even less. Sadly, dignity isn't a very highly valued commodity.

            I'd be surprised if he wasn't being paid well above market for his dignity.
            Are you married? If so, how much would you sell your spouse for? Would you take an offer for 25% above market?
            “Work” is a four letter word for good reason.

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            • #7
              Originally posted by Lithium View Post

              Are you married? If so, how much would you sell your spouse for? Would you take an offer for 25% above market?
              Market rate for spouses is way higher than the market rate for dignity.

              Market for happily married doctor spouses is approximately infinity. The rate for professional dignity is far lower.

              I'm beginning to wonder if you are familiar with these markets.

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              • #8
                Originally posted by ENT Doc View Post
                $2M
                I'd guess between 1 and 2 million myself. But I know nothing about psych billing, so this is a completely uneducated guess. I'm thinking closer to one million than two million, but I wouldn't be surprised if I was way off.

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                • #9
                  Originally posted by AR View Post

                  Market rate for spouses is way higher than the market rate for dignity.

                  Market for happily married spouses is approximately infinity. The rate for professional dignity is far lower.

                  I'm beginning to wonder if you are familiar with these markets.
                  You’re right, I’m not. My professional dignity is off the market. I’m curious how you acquired familiarity with these markets.
                  “Work” is a four letter word for good reason.

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                  • #10
                    Originally posted by Lithium View Post

                    You’re right, I’m not. My professional dignity is off the market. I’m curious how you acquired familiarity with these markets.
                    Relax, man. I'm just joking around.

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                    • #11
                      I’m guessing 3.5 to 4 million per yr before taxes...
                      Figuring each of the 7 see 20 pts per day. And each visit is 99214 which pays on avg $120 depending on payer.
                      maybe a little less for vacation time

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                      • #12
                        Originally posted by Dontgetthejab View Post
                        I’m guessing 3.5 to 4 million per yr before taxes...
                        Figuring each of the 7 see 20 pts per day. And each visit is 99214 which pays on avg $120 depending on payer.
                        maybe a little less for vacation time
                        Is that the amount that is reimbursed when a midlevel bills? Is it the same as when a doc bills for the same service?

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                        • #13
                          Originally posted by Dontgetthejab View Post
                          I’m guessing 3.5 to 4 million per yr before taxes...
                          Figuring each of the 7 see 20 pts per day. And each visit is 99214 which pays on avg $120 depending on payer.
                          maybe a little less for vacation time
                          That looks more like what gross revenue would be assuming each midlevel worked 48 5 day weeks per year based on your numbers.

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                          • #14
                            Originally posted by AR View Post

                            Is that the amount that is reimbursed when a midlevel bills? Is it the same as when a doc bills for the same service?
                            Reimbursement for midlevels is 85% of physicians reimbursement.
                            85% is about 3.4 million but if they code a higher acuity which in psych they likely can justify it for suicidal ideation/inpatient discharge follow up then I wouldn’t be surprised if higher. Also this place seems like herding cattle so they may see more than 20/day

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                            • #15
                              Originally posted by AR View Post

                              Is that the amount that is reimbursed when a midlevel bills? Is it the same as when a doc bills for the same service?
                              Keep in mind my numbers are based on 2020 cms physician fee schedule. The 2021 cme fee schedule actually increased the payment for outpatient visits up to about 20-30% more (caveat is not sure if all payers are honoring the cms increase), so I could be underestimating bigely depending on his payers

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