I am a pathologist recently approached by a GI colleague to consider reading biopsies that they will start taking in an in office endoscopy facility. What is the current fair market fee for this type of arrangement (fee per slide/jar)?. I have heard anywhere from $11 to $30 per slide/jar/88305. This is one of a few places where I have seen this discussed and would greatly appreciate any feedback to decide whether to consider this. Thanks!
GI fee per slide
- Thread starter DrPathMD
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The usual rate is per CPT code - there is a huge range dependent on location, payor mix, reimbursement rate, etc. I would ask around in your geographic area. But make sure it's CPT code (so you get paid for special stains, IHC, etc as well). In addition, make sure your contract spells out the arrangement for medical directorship (if any), turn around time expectations (if any), slide cap per day, and malpractice.
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$15 per 88305. Hell, ask for more if you can.
I spent $15 on a Chipotle bowl with double steak the other day because these stingy a)$ employees are told to just give one spoonful of meat.
You’ll be like the Chipotle of GI Path, but instead of cranking out bowls and burritos you’ll be cranking out TAs all day.
Instead of asking those gastroenterologists, “it’s extra for guacamole is that ok?” make sure you ask them “it’s extra for additional IHCs and special stains, is that ok?”
🥑🥑🥑🥑🥑🥑
I spent $15 on a Chipotle bowl with double steak the other day because these stingy a)$ employees are told to just give one spoonful of meat.
You’ll be like the Chipotle of GI Path, but instead of cranking out bowls and burritos you’ll be cranking out TAs all day.
Instead of asking those gastroenterologists, “it’s extra for guacamole is that ok?” make sure you ask them “it’s extra for additional IHCs and special stains, is that ok?”
🥑🥑🥑🥑🥑🥑
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I would ask for 20 per code. 17 would be a reasonable negotiation. If it were higher volume then maybe 15 would be ok.
mike-sheree
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It would be best if you can let the burden of “collections” fall on someone other than yourself. Collections can be crappy. You want to get paid per case/code regardless of collections. This is assuming that someone else is billing insurance/mc/patient primarily. Let them worry about the billing/collection circus. You get paid piece work regardless.
I would not do the percentage. Firstly I don't trust any GI office with doing accurate lab billing. Secondly, it is technically fee splitting which is non-compliant, although its not likely anyone would care. Flat fee is better and have it cover all codes.
We have been over this. One fee per code. Ask for 20 settle on 17 at the lowest. You can make money efficiently this way as long as the reporting allows you to build macros. Thats the advantage. Key stroke entry. I only have to type maybe on 5% of cases.
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Is it 20 per slide or per specimen?
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I would ask for something for medical director fee. They still need oversight to run the lab. If you do it for free, I am not sure it is very compliant. Also, I would keep detailed records of ALL of your cases and CPT codes that you charged per case. You're giving up your right to bill for these cases, but you're still partly responsible if any shenanigans are going on. Have your contract looked over by an experienced attorney, too.
mike-sheree
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As re: your CLIA, there aren’t too many inspection requirements. They (in my day) could be satisfied by CAP compliance. Get the check lists and pay attention to anything related to the applicable sections as they apply to the PC aspect of anatomical pathology. As Dave alluded, the procedure manual is a must and you can cover 95% of the requirements with that accomplished. You should get a director fee. There is a license involved with your name on it. You can only hold so many (?5) at one time. Therefore, each one has (potential) value.
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Just curious if you're doing this on the side/weekends as a current member in a larger practice or if you're a solo...
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so you're a currently an independent pathologist or just doing this solo on the side? GI fellowship trained?
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Interesting; had been curious if your GI colleague wanted GI trained or not.
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Five labs. See this CMS brochure for more information
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Some states will only allow 3
Some have a residency requirement - gotta actually live in the state so you can’t commute over state lines.
Arent you worried you are going to lose your surgpath skills the longer you stay at this GI only gig? If you were to try to get a hospital based position later on, I’m thinking groups would be concerned that you haven’t seen general surgpath for x number of years or however long you plan to stay there?
I’d recommend every junior pathologist out there get a busy hospital based job either in private or academics straight out of fellowship. Gain good signout experience at a busy hospital so you can be marketable later on if you want to switch jobs. If you are lucky to be at a busy place and you like your group then you are golden.
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I completely agree with this. I had assumed that the OP was asking about a side gig, not primary occupation.
