How much do you bill for IMEs?

[psychpro]

I am an ECP, and I was solicited on Linkedin by a medical expert organization. They are looking for psychologists to perform IMEs in cases of claims of childhood sexual abuse. The work will involve record review, an evaluation, and then writing a report. I am curious as to how folks typically bill for IMEs? Hourly? Or flat rate? How much for each typically. I plan on getting on a zoom call to ask more questions about the nature of the work, and the assessment question they would like me to answer but I thought it would be helpful to get a ballpark figure before I do so. Also any insight from folks who have worked with these types of agencies will be helpful.

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[texanpsychdoc]

I charge a flat rate of $2,000 for IMEs.

 

[Therapist4Chnge]

I never charge a flat rate bc you never know when someone will dump records and/or other BS on you. Sometimes a case has 30-50 pages to review and others could have 2500+ pages.

Only bill hourly. I’ll usually offer a ballpark idea of cost if they ask, but always specify it depends on the mix of records and if they require me to answer s bunch of specific interrogatories. I’ll check with them if the record review is 1500+ pages and I haven’t worked with them before, as some lawyers can have comically bad estimates for hours (on the low side).

You should be able to call bc around to local experts (or check their website) to get an idea of “the going rate.” I’m on the high side, but depending on your geographic location and mix of cases, the average rate can vary quite a bit. Never accept anything starting w. a 2, and never be the lowest or cases you will be offered are ones you won’t want.

 

[WisNeuro]

I'll second that, charge hourly. Last year, my IME times have ranged from 9 hours (simple case with only 200 pages of records) to 25 hours. Flat rate absolutely kills you on big cases. There are situations where there is a per assessment fee negotiated (government work, some large settlements), but you can still put guard rails on that (e.g., anything over X# of pages in review gets charged hourly; assessment goes over X hours, etc).

 

[NewNeuroDemic]

I am an ECP, and I was solicited on Linkedin by a medical expert organization. They are looking for psychologists to perform IMEs in cases of claims of childhood sexual abuse. The work will involve record review, an evaluation, and then writing a report. I am curious as to how folks typically bill for IMEs? Hourly? Or flat rate? How much for each typically. I plan on getting on a zoom call to ask more questions about the nature of the work, and the assessment question they would like me to answer but I thought it would be helpful to get a ballpark figure before I do so. Also any insight from folks who have worked with these types of agencies will be helpful.

For neuro IME, I charge $400 per hour for record review, writing, and testing. A flat $1000 clinic fee (I contract with my department to use facilities, supplies, etc.). And $550 per hour for depositions and testifying billed in 4-hour blocks.

 

[PsyDr]

I charge a flat rate of $2,000 for IMEs.

what kinda hobo, Oscar the grouch kinda rate is this? Why are you so cheap? Do they throw in a bus pass?

Bro/sis: you are wildly cheap. Wildly.

 

[texanpsychdoc]

what kinda hobo, Oscar the grouch kinda rate is this? Why are you so cheap? Do they throw in a bus pass?

Bro/sis: you are wildly cheap. Wildly.

I get it. Yeah, upon further reflection and consultation with others I have decided to up that to $400 an hour, plus incidental fees associated with records review in excess of 100 pages, and some other charges. One forensic psychologist I consulted with in Ohio advised me not to "nickel and time" people, especially being so early career, so I guess in some part I took that in mind. On the clinical side, I think I am on par with others regarding psychotherapy and assessments. I am still navigating the private practice forensic world in terms of $$.

 

[texanpsychdoc]

Bro/sis: you are wildly cheap. Wildly.

Fun fact - I identify as a dude, but depending on many beers I have had, I have been known to put on a good Margaret Thatcher persona.

 

[NewNeuroDemic]

I get it. Yeah, upon further reflection and consultation with others I have decided to up that to $400 an hour, plus incidental fees associated with records review in excess of 100 pages, and some other charges. One forensic psychologist I consulted with in Ohio advised me not to "nickel and time" people, especially being so early career, so I guess in some part I took that in mind. On the clinical side, I think I am on par with others regarding psychotherapy and assessments. I am still navigating the private practice forensic world in terms of $$.

The variations and differences of opinion from more senior folk fascinate me. (Anyone been keeping up with the NPsych listserv lately? Ohhhh boy.) The dude who is guiding me through IME stuff (I'm ECP too) advised to just charge the hourly rate accrued regardless of number of pages or whatever. The rationale being that that is exactly what lawyers do. If they have a 15 min phone call, you can bet that will be duly charged. So far, I have not had a single attorney balk or question my bill.

 

[psychpro]

The variations and differences of opinion from more senior folk fascinate me. (Anyone been keeping up with the NPsych listserv lately? Ohhhh boy.) The dude who is guiding me through IME stuff (I'm ECP too) advised to just charge the hourly rate accrued regardless of number of pages or whatever. The rationale being that that is exactly what lawyers do. If they have a 15 min phone call, you can bet that will be duly charged. So far, I have not had a single attorney balk or question my bill.

Would you be able to send me a link to that listserv? I don't think i'm part of it.

 

[PsyDWannabe]

The variations and differences of opinion from more senior folk fascinate me. (Anyone been keeping up with the NPsych listserv lately? Ohhhh boy.) The dude who is guiding me through IME stuff (I'm ECP too) advised to just charge the hourly rate accrued regardless of number of pages or whatever. The rationale being that that is exactly what lawyers do. If they have a 15 min phone call, you can bet that will be duly charged. So far, I have not had a single attorney balk or question my bill.

From what I hear, that listserv deserves it’s own thread on here 😂

 

[WisNeuro]

That listserv is a bit of the wild west. It ranges from some of the more experienced and knowledgeable in the field, to the Qeeg hacks. It can get kind of amateur hourish at times. I've largely abandoned the npsych listserv for the boarded listserv and another private npsych listserv.

 

[AcronymAllergy]

The variations and differences of opinion from more senior folk fascinate me. (Anyone been keeping up with the NPsych listserv lately? Ohhhh boy.) The dude who is guiding me through IME stuff (I'm ECP too) advised to just charge the hourly rate accrued regardless of number of pages or whatever. The rationale being that that is exactly what lawyers do. If they have a 15 min phone call, you can bet that will be duly charged. So far, I have not had a single attorney balk or question my bill.

Agreed, bill for your time. It's really only "wrong" if you're somehow artificially inflating the bill. But if the eval took 10 hours to get through or the report took 8 hours to write, then that's what it took.

 

[WisNeuro]

Agreed, bill for your time. It's really only "wrong" if you're somehow artificially inflating the bill. But if the eval took 10 hours to get through or the report took 8 hours to write, then that's what it took.

I will add that if you are abnormally slow at writing, the people paying you may not be happy with your bill. If you did a straightforward eval with minimal records, it'd be weird to take like 10+ hours to write a report when most people could do it in 3-4.

Granted, this is the same issue with clinical work, though I suspect some people are engaging in billing fraud. For example, a provider report I sw who did a standard dementia eval who charged 1 unit of 132 and 5 units of 133 for a heavy templated report.

 

[PsyDr]

Fun fact - I identify as a dude, but depending on many beers I have had, I have been known to put on a good Margaret Thatcher persona.

For over a decade, I honestly thought pragma was female. You’ll understand if I’m a bit more cautious these days.

Get paid.

 

[WisNeuro]

For over a decade, I honestly thought pragma was female. You’ll understand if I’m a bit more cautious these days.

Get paid.

I just thought he was an infant dinosaur who peaked in the early 90s.

 

[bcliff]

Mentors of mine have suggested billing the same out-of-pocket rates used at my primary place of employment. It might mildly suppress earnings, but it makes it easier to address concerns raised about financial motivation, etc. when testifying.

 

[texanpsychdoc]

Financial motivation: to pay my mortgage, truck payment, and a dozen eggs. You?

 

[Sanman]

Mentors of mine have suggested billing the same out-of-pocket rates used at my primary place of employment. It might mildly suppress earnings, but it makes it easier to address concerns raised about financial motivation, etc. when testifying.

Not sure about your primary place of employment. However, forensic work has increased risk of litigation against you and should be compensated as such. That's why they ask about it in the malpractice renewal forms.

 

[WisNeuro]

Mentors of mine have suggested billing the same out-of-pocket rates used at my primary place of employment. It might mildly suppress earnings, but it makes it easier to address concerns raised about financial motivation, etc. when testifying.

It's a ridiculous argument that never really plays well anyway. Regardless, my OOP clinical rate is the same as my hourly forensic rate. It just so happens that 100% of my clinical patients use their insurance anyway.

 

[AcronymAllergy]

And beyond that, if opposing council wants to say you're financially motivated, they'll find a way to do it regardless of how/how much you're paid.

 

[Sanman]

And beyond that, if opposing council wants to say you're financially motivated, they'll find a way to do it regardless of how/how much you're paid.

Isn't everyone except the parties involved in the litigation financially motivated? Is opposing council working for free? Is their expert?

You are paid for your time, not your conclusion.

 

[AcronymAllergy]

Isn't everyone except the parties involved in the litigation financially motivated? Is opposing council working for free? Is their expert?

You are paid for your time, not your conclusion.

Psssh, I do IMEs solely for the fun of it. I throw the payments straight in the trash.

 

[Sanman]

Psssh, I do IMEs solely for the fun of it. I throw the payments straight in the trash.

Please DM me with the location of your trash.

Also, if you you could see fit to cash the checks and throw the money in the trash, it would be appreciated. I have my eye on a boat, but free money is the only way that makes sense.

 

[AcronymAllergy]

Please DM me with the location of your trash.

Also, if you you could see fit to cash the checks and throw the money in the trash, it would be appreciated. I have my eye on a boat, but free money is the only way that makes sense.

The two happiest days in a boat owner's life...

 

[Therapist4Chnge]

The "how much do you charge" stuff is amateur hour in legal cases. There are always some people out there who are outrageous with how they bill, whether it is an obscenely high hourly rate or the overall total billing, so just don't be those people.