Is starting your own PP financially worth it?

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How do they pay a pension and not a 403b. Do you work in the last century?
i have been working for this system for 15 years...

and technically, i had an employee number in this system dating back to 1991.

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bob, why do all of your dates start with July 1?

for example, does "July1-Feb28 $488,167" mean that you made 488k from july 1 to feb 28, and that you made $900k from march 1 to june 30?
 
Yes. I’m showing how it takes time for the insurance to roll in and the practice to get more full.
 
Yes, a Medicare RFA patient adds up to $2500 and maybe $3200 if they might benefit from a LSO.
Sorry
How are you getting at $2500 for an RFA? Reimbursements from 2024 show reimbursement of $430.50. What other fees or codes do you add? Or is the reimbursement for just one level? ( eg x6 for bilateral l3-4, l4-5, l5-s1 would equal around 2500?)
 
1. Consult
2. LSO - I don’t actually give these patients an LSO but it is allowed
3. Bil two level mbb
4. F/U
5. Bil two level mbb
6. F/U
7. Bil two level RFA
8. F/u


That is probably over $2500

Then 6-12m later you might get another round
9. F/U
10. 2nd bil two level RFA
11. F/U



Ok, now time for their neck.
 
Gotcha
Thats the total patient. I was thinking on it was one visit

What percentage of a typical practice are medicare vs medicaid vs commercial? I would assume being mostly Medicare or medicaid would make it difficult for a practice to stay afloat.

Do you perform advance procedures also in a ASC? Maybe not your own but contracted to one?
 
I don’t think it makes much of a difference here. If my practice was all traditional Medicaid it would probably be exactly the same revenue. It pays a little better than Medicare. Not enough to worry about.

Yes, I do implants/lateral SI/mild, etc at an ASC or HOPD. I have a small ownership in an ASC which is fine since it is a fairly large 6 room center. That is fully optional and you technically lose money for time doing anything at a facility vs staying in your office if you are in private practice and don’t have ownership.


Example:

Pump implant pays a pro fee of like $500 Medicare. You are better off hanging out in your office doing anything else or taking time off to enjoy the outdoors - unless, you are an owner and the facility is profitable. It might not be. Or you are actively trying to build up your surgical practice for the chance to be offered ownership.

The facility I bought in was already profitable. So me joining, is accretive. After my implant costs, I’m not really increasing overhead otherwise and then I really turn up the profitability. Commercial DOES pay much, much better on the facility side. Some of the case profit is outlandish. But that gets diluted out to the other docs.


Hospital employed you can do big cases or not. However, you want to get your units.
 
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