Newest numbers for pure telepsych

[dl2dp2]

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Just got a phone call from two recruiters for large facilities in the NE (NY/NJ/PA). Just want to post here to save you guys the time.

ER W-2 $120 per eval evening and night hours, plus $50 per hour with or without any eval. -- this is a terrible rate, would never touch for nights/weekend hours.

"Private practice" (i.e. insurance) 1099 -- $120 per 45 min eval, $50 per 15 min f/u. -- this is what I would call an "average" job. However, the quality of care is suboptimal (to say the least)... most likely the majority of your f/us would be 5 min med checks. Is there value add for the telepsych agency there? I'm not sure. If I want to take that rate might as well directly contract with the facility...

Rates have gone up for sure. 3-5 years ago the same recruiter (Insight) was offering below $150 per hour.

Still, for the average MD the second job might be acceptable....

 

[Sushirolls]

This is the crux of so many jobs. Under pay, and/or under quality.

Final destination, open your place and make it what you want.

 

[dl2dp2]

This is the crux of so many jobs. Under pay, and/or under quality.

Final destination, open your place and make it what you want.

What would you say is your median 15-min 99213/4 reimbursement? $150? I can't imagine that overhead is 70% especially if you do pure telepsych.

 

[Sushirolls]

I have a blended formula I calculate now every quarter for 99213/99214 and pay rates proportional to my patient mix relative to their insurance. My last special sauce formula was about $135 per follow up for 2020 Q1. I did not include therapy add ons, nor 96127, nor smoking cessation add ons with this special sauce formula. The real number is actually higher, but this is still a bench mark that I use, and it works for me.

I do 30 minute follow ups.

In the coming years I anticipate a realistic goal of $170 per follow up with this special sauce formula.

You are right, if some one is doing 100% pure telepsych their overhead is much less, but should that justify devaluing your services and the profit be gifted to the telemedicine firm? I'm of the opinion a pay differential for telemedicine vs in office services will only hurt the outpatient office based docs and the field as a whole.

 

[dl2dp2]

In the coming years I anticipate a realistic goal of $170 per follow up with this special sauce formula.

You are right, if some one is doing 100% pure telepsych their overhead is much less, but should that justify devaluing your services and the profit be gifted to the telemedicine firm? I'm of the opinion a pay differential for telemedicine vs in office services will only hurt the outpatient office based docs and the field as a whole.

I agree. The number I quoted above is labor only. I think labor cost will be equivalent to in office as they will reimburse the same. I’m just looking at roughly the profit margin facility and telepsych agency make, which is about 50-70%

Kinda sad. If you practice this kind of psychiatry on your own you would gross twice as much as if you worked for a telepsych company.

 

[reca]

Actually called Insight today. They'll take nurse practitioners but not PGY-4 psychiatry residents.

 

[dl2dp2]

Actually called Insight today. They'll take nurse practitioners but not PGY-4 psychiatry residents.

That's not surprising. Wait a year. If you need money there are specific ways to moonlight as a PGY-4.

 

[reca]

That's not surprising. Wait a year. If you need money there are specific ways to moonlight as a PGY-4.

Ehh, a year from now I'm not going to have any interest in working for a telepsych company. At that point, it'll be about building my own practice and incorporating telepsych into that for interested patients. But yeah, there are local moonlighting opportunities as a PGY-3 and PGY-4 where I live, I was just hoping to work from home for moonlighting.

 

[Sushirolls]

If that's your plan to open your own practice and you are a PGY-4 now, start do your leg work. Eyes on office space to lease. Form your PLLC or LLC. Figure out your EMR, fax, billing, notes, policies, etc, etc, etc. Do as much of the prep work you can now. Or, better yet, lock in an office now, and open the doors with your own Telepsych service on weekends. 'moonlight for yourself' and start the process of getting credentialed with insurance if that's what you'll do.

 

[reca]

If that's your plan to open your own practice and you are a PGY-4 now, start do your leg work. Eyes on office space to lease. Form your PLLC or LLC. Figure out your EMR, fax, billing, notes, policies, etc, etc, etc. Do as much of the prep work you can now. Or, better yet, lock in an office now, and open the doors with your own Telepsych service on weekends. 'moonlight for yourself' and start the process of getting credentialed with insurance if that's what you'll do.

Really good advice, thanks. Do you mind if I PM you? I'm still a PGY-3 (was looking for moonlighting opportunities for next year).

 

[clausewitz2]

Got pitched by a tele outfit local to my state. $130 per scheduled hour regardless of whether patients show up. 60 minute new evals and 15 minute follow-ups. If 30 hours or more than eligible for full benefits, otherwise 1099. They cover malpractice including tail. Pre-Covid they were not set up to prescribe controlled substances so not a pill mill at least.

They only wanted a minimum commitment of 40 hours per month anytime between 7AM and 11 PM, asked that if at all possible new evals be between 8 and 8. Lots of flexibility in scheduling although preference for 5 hour chunks. Claimed it was a "virtual group practice" with ownership of patients.

The money's obviously not amazing but guaranteed is nice and the included malpractice coverage and admin support + no commute + off hours is somewhat attractive. I have a couple better offers for the hours I would have for them so will probably pass, but nice to have as a fall back

 

[Sushirolls]

Really good advice, thanks. Do you mind if I PM you? I'm still a PGY-3 (was looking for moonlighting opportunities for next year).

Sure.