Earning Potential For Assessment Focused Practitioners?

[ThatPsyGuy]

Just curious about the earning potential for people focused on assessment. I talked to someone today who mentioned how the earning potential is high.

I'm familiar with the Sweet survey and Neuropsych earning potentials, but I'm curious about personality, intellectual, ADHD, behavioral, etc assessments.

There's probably lots of factors that go into it, but a general idea would be neat.

But some example questions:
What's the usual pay per assessment? (Or general range for all of them?)
How many assessments do people usually crank out a week? Do you even need to administer them yourself if you have technicians? (And how does this usual affect pay?)
Why do I feel like a little detective when report writing and when did I get a monocle and pipe? (Does it go away?)

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[calimich]

I agree with that someone you talked with. Earning potential is high. Supply and demand, taking on some risk drive the price up, imo. It also seems we're even more secretive about assessment fees & practice than therapy.

Some of my guesses and actual practice:
I imagine the pay range is wider than therapy. $150-500/hr? or a flat fee of $500-5K? (I charge $1250, ~4-8 hours)
Again, varies widely I imagine from 1 or 2/week to 10/week? (I do 1 or 2 per month)
Like therapy, technology has increased access and has made remote administration more secure and easier, however one must always consider validity and the particular population being assessed. Technicians need to be paid for what they do. (I don't use any, although I've been encouraged to hire one)
The detective feeling has not gone away.

I really enjoy the change from therapy, the detective feeling (for me it's like putting a puzzle together), and the brief nature of our relationships. Especially compared to outpatient pp therapy, where most folks have been with me for some time, the freshness of assessment cases is nice. Assessment also allows for more time off and extended breaks, imo. I'm slowly shifting to more assessment as the sabbatical gets closer so I can pick up some cases, complete them, and get back to sabbaticaling, rather than continually interrupt therapy clients.

 

[WisNeuro]

Are you interested in IMEs for psych diagnoses? Specifically PTSD? If so, earning potential is much higher.

 

[iliketohelppeople]

I agree with that someone you talked with. Earning potential is high. Supply and demand, taking on some risk drive the price up, imo. It also seems we're even more secretive about assessment fees & practice than therapy.

Some of my guesses and actual practice:
I imagine the pay range is wider than therapy. $150-500/hr? or a flat fee of $500-5K? (I charge $1250, ~4-8 hours)
Again, varies widely I imagine from 1 or 2/week to 10/week? (I do 1 or 2 per month)
Like therapy, technology has increased access and has made remote administration more secure and easier, however one must always consider validity and the particular population being assessed. Technicians need to be paid for what they do. (I don't use any, although I've been encouraged to hire one)
The detective feeling has not gone away.

I really enjoy the change from therapy, the detective feeling (for me it's like putting a puzzle together), and the brief nature of our relationships. Especially compared to outpatient pp therapy, where most folks have been with me for some time, the freshness of assessment cases is nice. Assessment also allows for more time off and extended breaks, imo. I'm slowly shifting to more assessment as the sabbatical gets closer so I can pick up some cases, complete them, and get back to sabbaticaling, rather than continually interrupt therapy clients.

@calimich, what types of assessments/referral questions do you target? I have a TT job, but would be interested in starting a limited practice on the side. I would really prefer assessment, as I enjoy that domain, but am curious about how much of a market there is for non-neuro types of assessments.

 

[calimich]

@iliketohelppeople personality/vocational, with requests for school-based.
a supervisor of mine used to say, parents will always pay!

 

[ThatPsyGuy]

Are you interested in IMEs for psych diagnoses? Specifically PTSD? If so, earning potential is much higher.

What makes PTSD have a higher earning potential? I'm imagining it has something to do with the VA?

 

[WisNeuro]

What makes PTSD have a higher earning potential? I'm imagining it has something to do with the VA?

Not VA related, for the most part, for the farmed out VA work, the pay is garbage. It's more that PTSD is a diagnosis that comes up more often in personal injury cases, hence there is a decent amount of work in that arena for those who can assess for it adequately.

 

[Therapist4Chnge]

What makes PTSD have a higher earning potential? I'm imagining it has something to do with the VA?

Someone will pay for that, as opposed to a more generic "psych" testing. I haven't taken commercial insurance in years, but I suspect they are just as stingy or moreso in regard to the use of psych testing. PTSD eval for the VA, workers comp, or similar can probably be a decent to good niche. The non-neuro evals I do include pre-surg eval, chronic pain eval (typically bc of reports of incongruent somatic complaints), and PTSD evals. The 3rd party companies that farm out evals should be avoided. If I do a PTSD eval it is almost always for workers comp, as they will pay for them and it's honest work. Being hired by a plaintiff attorney to eval for PTSD is another animal all together.

 

[AbnormalPsych]

Someone will pay for that, as opposed to a more generic "psych" testing. I haven't taken commercial insurance in years, but I suspect they are just as stingy or moreso in regard to the use of psych testing. PTSD eval for the VA, workers comp, or similar can probably be a decent to good niche. The non-neuro evals I do include pre-surg eval, chronic pain eval (typically bc of reports of incongruent somatic complaints), and PTSD evals. The 3rd party companies that farm out evals should be avoided. If I do a PTSD eval it is almost always for workers comp, as they will pay for them and it's honest work. Being hired by a plaintiff attorney to eval for PTSD is another animal all together.

How does one get into the world of workers comp PTSD evals?

 

[foreverbull]

Just curious about the earning potential for people focused on assessment. I talked to someone today who mentioned how the earning potential is high.

I'm familiar with the Sweet survey and Neuropsych earning potentials, but I'm curious about personality, intellectual, ADHD, behavioral, etc assessments.

There's probably lots of factors that go into it, but a general idea would be neat.

But some example questions:
What's the usual pay per assessment? (Or general range for all of them?)
How many assessments do people usually crank out a week? Do you even need to administer them yourself if you have technicians? (And how does this usual affect pay?)
Why do I feel like a little detective when report writing and when did I get a monocle and pipe? (Does it go away?)

These are great questions. I’ve considered the same path (many times) but haven’t invested because I don’t have a referral source and am hesitant to invest in even consultation with an assessment provider, let alone purchasing assessments. Other folks I know had connections to get started (ie from grad school or past jobs in the area).

I’m curious: folks who started out in private practice and built an assessment niche, how did you find a way starting out without a referral source initially?

 

[Mojito_15]

@iliketohelppeople personality/vocational, with requests for school-based.
a supervisor of mine used to say, parents will always pay!

This is a great idea...

 

[WisNeuro]

This is a great idea...

Parents will definitely pay for certain assessments. But they also tend to get very angry if the results are not what they want them to be

 

[Mojito_15]

Parents will definitely pay for certain assessments. But they also tend to get very angry if the results are not what they want them to be

See- I know this- I was a public school psychologist and had many a parent yell at me about their IEP. But I feel like they'd be less likely to yell if I did not have to tell them their child was intellectually disabled and instead was just doing vocational counseling.

 

[WisNeuro]

See- I know this- I was a public school psychologist and had many a parent yell at me about their IEP. But I feel like they'd be less likely to yell if I did not have to tell them their child was intellectually disabled and instead was just doing vocational counseling.

You underestimate how much people want their child to have a certain diagnosis that they 'paid' for.

 

[PsyDWannabe]

These are great questions. I’ve considered the same path (many times) but haven’t invested because I don’t have a referral source and am hesitant to invest in even consultation with an assessment provider, let alone purchasing assessments. Other folks I know had connections to get started (ie from grad school or past jobs in the area).

I’m curious: folks who started out in private practice and built an assessment niche, how did you find a way starting out without a referral source initially?

Sometimes the most obvious way is the simplest way. You put on your big girl pants/big boy pants, hit the road, and market yourself. For us peds people, I’ve heard very good things about walking into private schools and introducing yourself since they rarely have a full-time assessment psychologist on staff and those parents are typically not limited by funds in terms of paying out of pocket to get their kids the necessary services.

 

[Therapist4Chnge]

Sometimes the most obvious way is the simplest way. You put on your big girl pants/big boy pants, hit the road, and market yourself. For us peds people, I’ve heard very good things about walking into private schools and introducing yourself since they rarely have a full-time assessment psychologist on staff and those parents are typically not limited by funds in terms of paying out of pocket to get their kids the necessary services.

I've known a number of clinicians who have made $$$ catering to private school parents. Obviously you need to have good boundaries and make sure the parents understand that it's an assessment and not a rubber stamp, but a halfway decent psych should be able to be full once the word-of-mouth gets going with the parents. There likely will already be someone in that space, so it won't be available on a silver platter, but usually a little bit of research and effort can pay off nicely.

 

[ThatPsyGuy]

Hey, bringing this back up. But I've been trying to do a little more research on exactly what encompasses Psych Evals/Assessments and hat exactly encompasses Neuropsych evals/assessments.

For example, I saw a lot of conflicting information regarding what constitutes a psych eval vs a neuropsych eval. A group practice website said that Autism disorders, intellectual disabilities, "giftedness", and ADHD. But I'm pretty sure those can be done from a regular psych.

Where exactly is the line drawn on what a psych vs a neuropsych can do? ....And what's the difference in earning potential once again.
Just kinda finding clarification. I'm fairly certain I don't want to specialize in neuropsych though.

 

[WisNeuro]

Hey, bringing this back up. But I've been trying to do a little more research on exactly what encompasses Psych Evals/Assessments and hat exactly encompasses Neuropsych evals/assessments.

For example, I saw a lot of conflicting information regarding what constitutes a psych eval vs a neuropsych eval. A group practice website said that Autism disorders, intellectual disabilities, "giftedness", and ADHD. But I'm pretty sure those can be done from a regular psych.

Where exactly is the line drawn on what a psych vs a neuropsych can do? ....And what's the difference in earning potential once again.
Just kinda finding clarification. I'm fairly certain I don't want to specialize in neuropsych though.

I don't touch evals for ADHD, autism, ID, or giftedness. A neuropsychologist could do these evals, but I would put the in a general "psych assessment" bucket.

 

[NeuroTrope]

I know folks who bring in between 500k-2mm per year. 2mm folks run bigger practices though.

 

[WisNeuro]

I know folks who bring in between 500k-2mm per year. 2mm folks run bigger practices though.

Yeah, you're not bringing in 2 mil unless you have employees or are doing high profile legal cases.

 

[NeuroTrope]

Yeah, you're not bringing in 2 mil unless you have employees or are doing high profile legal cases.

I know two people who are. But yes they have employees and run a large-scale business.

 

[Sanman]

I know two people who are. But yes they have employees and run a large-scale business.

So then everyone agrees, you are unlikely to bring that in with a solo practice. That said, I feel like the the distinction between therapy and assessment is pointless. At this stage, what you do run a large-scale business. What the people who work for you doesn't really matter.

 

[ClinicalABA]

I don't touch evals for ADHD, autism, ID, or giftedness. A neuropsychologist could do these evals, but I would put the in a general "psych assessment" bucket.

Yep- I'm not a neuropsychologist (though there are no legal requirements or restrictions on calling yourself that as long as you are a licensed psychologist). I do primarily ASD evals bill neuropsych CPT codes for them. I occasionally do some basic "neuropsych" tests, but would never consider myself a neuropyschologist.

 

[WisNeuro]

Yep- I'm not a neuropsychologist (though there are no legal requirements or restrictions on calling yourself that as long as you are a licensed psychologist). I do primarily ASD evals bill neuropsych CPT codes for them. I occasionally do some basic "neuropsych" tests, but would never consider myself a neuropyschologist.

Outside of a couple states, this is true. Though one can be referred to the board for doing neuropsych assessment without appropriate training, licensed or not.

 

[Sanman]

Outside of a couple states, this is true. Though one can be referred to the board for doing neuropsych assessment without appropriate training, licensed or not.

The issue, depending on the type of assessment, would what constitutes appropriate training. Our fellowship and board certification model is not as standardized as medicine. I mean I never had a board certified neuropsych professor.

 

[WisNeuro]

The issue, depending on the type of assessment, would what constitutes appropriate training. Our fellowship and board certification model is not as standardized as medicine.

There are some grey areas, for sure. But, there are clear examples here and there.

 

[Mojito_15]

I don't touch evals for ADHD, autism, ID, or giftedness. A neuropsychologist could do these evals, but I would put the in a general "psych assessment" bucket.

This is interesting because school psychologists identify ID and gifted with Ed.S. degrees.

 

[PsyDr]

Yeah, you're not bringing in 2 mil unless you have employees or are doing high profile legal cases.

Those numbers are likely GROSS, not NET. Grossing $2MM is nothing, if you have 50 employees. Netting $2MM with 50 employees is impossible (i.e., 2000hr work year, 70% of hours being billable, reimbursement of 90/hr after insurance clawbacks and nonpayment, median salary of $130k or so). Netting $2MM in solo practice is not possible. You'd have to charge over $1000/hr , have zero non-billable hours, never have commute time for court, never be sick, never pay for office or staff, AND be full.

FYI: High profile cases tend to be criminal, and are publicly funded. Those pay really really really bad.

 

[Sanman]

Those numbers are likely GROSS, not NET. Grossing $2MM is nothing, if you have 50 employees. Netting $2MM with 50 employees is impossible (i.e., 2000hr work year, 70% of hours being billable, reimbursement of 90/hr after insurance clawbacks and nonpayment, median salary of $130k or so). Netting $2MM in solo practice is not possible. You'd have to charge over $1000/hr , have zero non-billable hours, never have commute time for court, never be sick, never pay for office or staff, AND be full.

FYI: High profile cases tend to be criminal, and are publicly funded. Those pay really really really bad.

Pay them $90k instead of $130k and you will have your $2MM and a lot of turnover.

 

[PsyDr]

Pay them $90k instead of $130k and you will have your $2MM and a lot of turnover.

Naw. There’s an issue of scale. As you ramp up, your costs become dynamic. You’d still have overhead, but you are now obligated to pay for healthcare insurance, your states workers comp dues and employment taxes, malpractice insurance, standing retainer for attorneys, dedicated billing and reception, etc. Even if you bought the offices, and getting $100/hr, you’re still barely making it at 70% efficiency. That’s why every employer pushes more work, and the use of technicians. If you get employees to work at 90% billables, it’s much easier. But psychologists are lazy.

Throw in technicians, and you’re making bank. It’s just a recipe for burn out and putting yourself out of business.

 

[NeuroTrope]

Not all psychologists are lazy. I mean I get what's being said here but these guys run smaller high med-legal/work comp practices. FWIW you can absolutely earn north of 1mm NET doing just assessments in a big city if you are successful. But sure, it's an outlier thing. 500-800k is totally reasonable.

 

[David J]

Just curious about the earning potential for people focused on assessment. I talked to someone today who mentioned how the earning potential is high.

I'm familiar with the Sweet survey and Neuropsych earning potentials, but I'm curious about personality, intellectual, ADHD, behavioral, etc assessments.

There's probably lots of factors that go into it, but a general idea would be neat.

But some example questions:
What's the usual pay per assessment? (Or general range for all of them?)
How many assessments do people usually crank out a week? Do you even need to administer them yourself if you have technicians? (And how does this usual affect pay?)
Why do I feel like a little detective when report writing and when did I get a monocle and pipe? (Does it go away?)

Hello, first post on this site.

To answer your question, it depends in part on your network of contacts, and whether you manage your own caseload or work for someone else.
I work in a government town, so we get many fitness to work assessments for government employees. Many requests for military, police, paramedics as well. Regular requests for the courts as well, mostly civil cases but also criminal.
Basically, the best work you do, the more you become known, the more requests you get. So the initial few years are crucial; don't expect to make tons of money from the get-go but work hard and you will reap the rewards later. I bet Shannon Curry is getting tons of referrals now...
In my case pay is roughly 1500$ an assessment but I undercut myself since I absolutely insist on doing projectives on most assessments, which takes a lot longer. But my main job is as a university faculty so I can afford to make a bit less on the clinical side. My neuropsych colleagues at the clinic always have a full caseload and they're always on the go, so they obviously make much more.
I do interviewing and projective assessment myself, all the self-report questionnaire stuff is done by a psychometrician. I just interpret the protocols and do the writeup. I could probably complete a couple of assessments a week if I worked full time.
The "detective" part relates to the dual use of both deductive and inductive reasoning. It is what makes assessment work interesting and stimulating.

 

[PsyDr]

Not all psychologists are lazy. I mean I get what's being said here but these guys run smaller high med-legal/work comp practices. FWIW you can absolutely earn north of 1mm NET doing just assessments in a big city if you are successful. But sure, it's an outlier thing. 500-800k is totally reasonable.

If I had to guess about who you are taking about, they don’t earn $1MM net from assessments. They earn it from hiring people at a 50/50 split and have 2 other lines of business.

WC is typically 185% of Medicare rates.

 

[NeuroTrope]

If I had to guess about who you are taking about, they don’t earn $1MM net from assessments. They earn it from hiring people at a 50/50 split and have 2 other lines of business.

No.

WC is typically 185% of Medicare rates.

Re-read the title of this thread and extrapolate which state I'm in.

 

[Therapist4Chnge]

If I had to guess about who you are taking about, they don’t earn $1MM net from assessments. They earn it from hiring people at a 50/50 split and have 2 other lines of business.

WC is typically 185% of Medicare rates.

I'm thinking about a guy in Florida, who sold the practice in the past few years?

 

[PsyDr]

Re-read the title of this thread and extrapolate which state I'm in.

If I'm wrong about who you are talking about, I am wrong.

Re-read my posts, extrapolate how much I know about forensic practice.

I'm thinking about a guy in Florida, who sold the practice in the past few years?

I’m guessing more of that two person group.

 

[NeuroTrope]

This talk of WC pays "185%" of Medicare rates is just wrong. ML201 with the psych modifier and record review above 50 pages is all you need to know.

 

[WisNeuro]

This talk of WC pays "185%" of Medicare rates is just wrong. ML201 with the psych modifier and record review above 50 pages is all you need to know.

Those no-show rates suck.

 

[PsyDr]

This talk of WC pays "185%" of Medicare rates is just wrong. ML201 with the psych modifier and record review above 50 pages is all you need to know.

Here I thought 99358 was record review, which is all you need to know.

 

[NeuroTrope]

Anything CPT makes me want to run away. But California is its own island and I recognize it differs state to state. I guess do you prefer the rodeo of civil litigation or the Brazilian dystopia of work comp? Both have their merits...

 

[PsyDr]

Anything CPT makes me want to run away. But California is its own island and I recognize it differs state to state. I guess do you prefer the rodeo of civil litigation or the Brazilian dystopia of work comp? Both have their merits...

So you don't know about CPT codes, but are sure my statement about the rates is wrong.

 

[NeuroTrope]

Don't be obtuse. I have no reason to embellish. I do know about CPT codes - they are billed alongside ML rates. But they are a fraction of ML rates. To spell it out, WC med-legal assessments can pay bucko bucks if you know what you're doing.

 

[PsyDr]

Don't be obtuse. I have no reason to embellish. I do know about CPT codes - they are billed alongside ML rates. But they are a fraction of ML rates. To spell it out, WC med-legal assessments can pay bucko bucks if you know what you're doing.

I see. When you say that you run away from CPT codes, it isn't obtuse or embellishing?

I know a little bit about forensics and workers comp.

*And it's spelled "beaucoup". From the French word for "many".

 

[NeuroTrope]

I see. When you say that you run away from CPT codes, it isn't obtuse or embellishing?

It's more hyperbole.

I know a little bit about forensics and workers comp.

I'm sure you do. But you seem to be missing something here.

*And it's spelled "beaucoup". From the French word for "many".

Any word that sounds like "BooKoo" can be spelled as one feels in the moment. I guess pedantic is another good word for you.

 

[WisNeuro]

Any word that sounds like "BooKoo" can be spelled as one feels in the moment. I guess pedantic is another good word for you.

To be fair, "bucko bucks" sounds like something you win from carnival games at the Tulsa Rodeo and can redeem for other toys, like the giant stuffed animal armadillo, or an AR-15. Have to agree with the pedantry for this specific item.

 

[Therapist4Chnge]

Don't be obtuse. I have no reason to embellish. I do know about CPT codes - they are billed alongside ML rates. But they are a fraction of ML rates. To spell it out, WC med-legal assessments can pay bucko bucks if you know what you're doing.

From my experience....(Most) Commercial Insurance > Medicare > WC (in some states) > WC ML > Medical Legal.

If someone wants to run a Gero practice and work on volume, MC can work, but the better money can be in WC, WC ML, and ML. A lot of clinicians don't want anything to do with legal work, and that works well for the rest of us.

 

[Sanman]

From my experience....(Most) Commercial Insurance > Medicare > WC (in some states) > WC ML > Medical Legal.

If someone wants to run a Gero practice and work on volume, MC can work, but the better money can be in WC, WC ML, and ML. A lot of clinicians don't want anything to do with legal work, and that works well for the rest of us.

Curious about this as it is not my wheelhouse. What is the difference in WC vs WC ML work/rates?

also shouldn't the signs be going the other way for greater than (sorry, just being pedantic)

 

[Therapist4Chnge]

Curious about this as it is not my wheelhouse. What is the difference in WC vs WC ML work/rates?

also shouldn't the signs be going the other way for greater than (sorry, just being pedantic)

haha...you fell for my pendandic trap!! Or I posted w/o checking.

From my understanding (at least in my state), there is WC related medico legal work, and the fees are set and paid by the WC insurance. For regular medico legal work, the expert sets their own fee schedule. The WC ML fees in my experience are 1.5x-2x clinical rates, but less than straight medico legal work.

 

[Sanman]

haha...you fell for my pendandic trap!! Or I posted w/o checking.

From my understanding (at least in my state), there is WC related medico legal work, and the fees are set and paid by the WC insurance. For regular medico legal work, the expert sets their own fee schedule. The WC ML fees in my experience are 1.5x-2x clinical rates, but less than straight medico legal work.

I just assumed you really like dealing with Cigna/Bravo and Kaiser over making ML and WC money. I was like....good for you!

 

[Therapist4Chnge]

I just assumed you really like dealing with Cigna/Bravo and Kaiser over making ML and WC money. I was like....good for you!

I left commercial insurance 5+ years ago and don't miss it one bit. Taking WC isn't perfect, but they pay well enough for assessment work I tolerate the occasional peer-to-peer. In prior states it was much more adversarial and getting psych services was like pulling teeth. Now I have some WC companies calling/begging to see their worker bc they know they need psych and/or assessment to get the case unstuck.