Fair child psychiatrist fee

[Madden007]

So I'm a bit torn. I do not want to take insurance for obvious reasons (HASSLE). But, I do not want to feel scumbaggy, as one preying on or getting rich off desperate parents, or providing care only to those who can afford it. Fortunately, many folks can submit claims to their insurance company afterwards to get reimburse of some or all fees. That makes me feel better. But, what is a fair fee to charge patients in non-major city locations? Any thoughts?

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[PistolPete]

What do you feel that your time is worth? Whatever that is is the fair rate.

 

[dl2dp2]

This is extremely location dependent. What I would do is to call around locally and get a sense of what the market rate is, and go from there. Don't worry about the "desperate parents" factor. If your fees are too high, patient won't come. It's a market economy.

If you really want to help out you can always work part time at a CMHC.

 

[calvnandhobbs68]

not to add to your guilt haha but I wouldn't count on people being able to get reimbursed. They'll be paying straight up out of pocket on high deductible plans until they hit that deductible and after that they'll get covered at the "out of network" rate which will probably be something like 50% of "usual and customary" fees if they're lucky.

 

[nitemagi]

This is a fair thing to think about. I would keep in mind that "taking advantage" is a relative thing -- meaning if your rate is below others around you, in a sense you're then offering a service. Some people will view you as predatory no matter what, or just not doable. Some will choose not to come at all. You have a choice about how much you want to make it easy, but recognize that there's drawbacks to lowering your fee. Some docs do a sliding scale, for those that ask. Others will charge what they want and take some pro bono cases to balance it out.

 

[milesed]

They can always file a claim with their insurance on their own (may need a copy of your note).

 

[vistaril]

They can always file a claim with their insurance on their own (may need a copy of your note).

As calv points out, that's not the way it usually works. Usually when a patient asks for a super bill, they are using it to be able to use their hsa money and not actually have their insurance cover it(they may try but only a small percentage get it to happen)

This fantasy that we can completely do away with the hassles of insurance, charge whatever we want, and patients can still get reimbursed by their insurance is just that....a fantasy.

 

[whopper]

The colleagues I have in my office charge $450 an hour.
I don't charge that much but it's not because I have to do so. I'm charging $300/hr but also taking in Medicare patients and a few insurances just cause I get kind of annoyed when all of my patients are well-to-dos with a lot of money. I like a mix. I could charge $450 at any time and I'd still have the same patients paying out of pocket.

 

[Blitz2006]

The colleagues I have in my office charge $450 an hour.
I don't charge that much but it's not because I have to do so. I'm charging $300/hr but also taking in Medicare patients and a few insurances just cause I get kind of annoyed when all of my patients are well-to-dos with a lot of money. I like a mix. I could charge $450 at any time and I'd still have the same patients paying out of pocket.

Well I know a child psychiatrist in Long Island that charges $400/hr, and in Manhattan $700. I believe 700 is extreme though. I think average in NYC area is 500.

But I'm just guessing

 

[PistolPete]

The colleagues I have in my office charge $450 an hour.
I don't charge that much but it's not because I have to do so. I'm charging $300/hr but also taking in Medicare patients and a few insurances just cause I get kind of annoyed when all of my patients are well-to-dos with a lot of money. I like a mix. I could charge $450 at any time and I'd still have the same patients paying out of pocket.

Is this for a 50 minute appointment? Or $150 for 30 minute med check with therapy?

 

[Madden007]

I, like everyone else, have a desire to make as much money as possible. But, when it comes to caring and treating children, no one else feels grimy about milking the most out of sick children's parents simply because the market allows you to? Help me understand. Thanks.

 

[TexasPhysician]

I can throw a rock and hit 10 contractor jobs paying $140-150/hr. If I am putting in the sweat and risk to build my own practice, I expect to earn $170+/hr after expenses.

 

[SmallBird]

I, like everyone else, have a desire to make as much money as possible. But, when it comes to caring and treating children, no one else feels grimy about milking the most out of sick children's parents simply because the market allows you to? Help me understand. Thanks.

If it makes you feel better (and it may not, but it does me somehow), seeing a private patient as a child psychiatrist and charging $400 for an hour of high quality assessment, careful treatment planning and therapeutic communication is an absolute steal when compared to the cost of delivering the same level of service through medicaid. The intake procedures, documentation burden, associated needs for ancillary staff mean that patients one is seeing in these contexts are receiving about half the amount of true contact time, and at lower quality owing to the need to contort service delivery around bizarre outcome metrics, rapid staff turnover, and inability to recruit high quality staff. The state may only end up paying about $170 for this but owing to it being ineffective, kids are likely to need more intensive services (such as in home or intensive outpatient) which bill medicaid around $5000 per month. Weekly office based treatment is the best option for a significant number of patients, and if psychiatrists could be paid $400 to do this in an unencumbered fashion I think we would save insurance and medicaid money. Hey, I'd do it for $200.