If you are licensed in multiple states, can you charge different rates for PP? I love to hear folks' REAL experiences.

[peanutspeanuts]

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A newb here!

Given active access to virtual modality, I'm surprised this question has not come up in the past.

It'd be valuable to hear how folks with licenses in multiple states have dealt with different rates in private practices and their thought processes!

For example, if a psychologist is licensed in Oklahoma and New York, where there are vast differences in cost of living, would it make sense to have a pay scale (rather than a fixed fee)? If so, based on what factors have you charged them differently?

Thank you all!

 

[Sanman]

You are correct, but why does that matter? If I am running a solo/part-time practice, I just want a few folks that can pay me. I don't care where they live. If you want more, maybe. However, then you have to consider insurance reimbursement and whether that works out better.

 

[PsyDr]

You MUST charge different rates. This requirement is based upon the idea of "usual and customary rate". Most insurers adjust locality based reimbursement using UCRs. Because most of malpractice is based upon the practices of the local community, there are implications for fee schedules that deviate from the charges of the local community.

All insurers pay differently if you are in OK vs NY. It's not like they are doing this out of the kindness of their hearts.

There are MANY state laws that make a telehealth based practices not viable in some states.

 

[peanutspeanuts]

You MUST charge different rates. This requirement is based upon the idea of "usual and customary rate". Most insurers adjust locality based reimbursement using UCRs. Because most of malpractice is based upon the practices of the local community, there are implications for fee schedules that deviate from the charges of the local community.

All insurers pay differently if you are in OK vs NY. It's not like they are doing this out of the kindness of their hearts.

There are MANY state laws that make a telehealth based practices not viable in some states.

Thank you for your helpful response! If this was a self-pay (no insurance involved), would it still be a MUST to charge different rates?

 

[peanutspeanuts]

You are correct, but why does that matter? If I am running a solo/part-time practice, I just want a few folks that can pay me. I don't care where they live. If you want more, maybe. However, then you have to consider insurance reimbursement and whether that works out better.

Right. This would be a self-pay gig, no insurance involved. Given that NY rate for psychotherapy is significantly higher than rural areas like OK, I was curious how folks have dealt with rates.

 

[PsyDr]

Thank you for your helpful response! If this was a self-pay (no insurance involved), would it still be a MUST to charge different rates?

Maybe, maybe not.

There are several factors at play here, to include:

1) The relevant federal laws, which you can pay an attorney to learn about
2) Specific state law, including licensing, insurance, and consumer law. The latter is a huge issue with substantial case law.
3) No Surprises Act
4) State laws about balance billing
5) Some way to defend this in the inevitable board complaint.
6) If the state has adopted APA Ethics into law.

 

[peanutspeanuts]

There are many different variables to consider. I would really appreciate hearing from folks who actually hold licenses in multiple states and hearing how you addressed the rate question.

 

[peanutspeanuts]

Maybe, maybe not.

There are several factors at play here, to include:

1) The relevant federal laws, which you can pay an attorney to learn about
2) Specific state law, including licensing, insurance, and consumer law. The latter is a huge issue with substantial case law.
3) No Surprises Act
4) State laws about balance billing
5) Some way to defend this in the inevitable board complaint.
6) If the state has adopted APA Ethics into law.

Thanks so much for taking time to respond! So helpful. Which body of authority might be a good place to begin asking this question to? Would APA Ethics be a good place to start asking these questions? What would I search to find a lawyer who can answer this question? I'm not versed in "law," so I wouldn't even know what to type...

 

[deleted1129370]

I'm licensed in multiple states and have PSYPACT. I charge the same regardless. Makes no sense to alter pricing. It's simple - they can either afford it or not. You cast a wide net, you get plenty of people who can.