Part time income?

[ProteusM]

I'm a PGY-2 and while I still respect the importance of good psychiatric care I don't feel the passion for the field I did as a student. Already starting to daydream about going part time after residency. I'm fortunate that I don't have a big debt burden and am wondering about what kind of earnings I could expect working about 3 days per week in a private practice (group or solo) or CMHC. Can anybody offer insight there? I plan to work hard and serve my patients well while I'm at work, but really would like to have more time to do things I'm passionate about- family and some creative endeavors. I would certainly like to make >100k and 150k would be ideal. How feasible are those goals? In particular how feasible is it to have a private practice with overhead for office space, billing, etc working 3 days? Are there good ways to split those costs? I can get essential benefits through my husband's job. Thanks for any pointers!

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[wolfvgang22]

Private practice probably wouldn't be feasible, but locums might work out.

 

[Merovinge]

I'm a PGY-2 and while I still respect the importance of good psychiatric care but I don't feel the passion for the field I did as a student. Already starting to daydream about going part time after residency. I'm fortunate that I don't have a big debt burden and am wondering about what kind of earnings I could expect working about 3 days per week in a private practice (group or solo) or CMHC. Can anybody offer insight there? I plan to work hard and serve my patients well while I'm at work, but really would like to have more time to do things I'm passionate about- family and some creative endeavors. I would certainly like to make >100k and 150k would be ideal. How feasible are those goals? In particular how feasible is it to have a private practice with overhead for office space, billing, etc working 3 days? Are there good ways to split those costs? I can get essential benefits through my husband's job. Thanks for any pointers!

It's doable if you are known in the area and the area is affluent enough to provide either A) Cash pay or B) A single good PPO plan that pays well for 99214 +90833. The key to this type of practice is aggressively minimizing overhead, this will involve you need to manage the business side of things and the clerical side of things. Don't spring for crazy expensive office space or furniture. You will also need a plan to be on-call after hours for your patients. If you really want to make it happen, it can be done, and hey if you end up liking it and doing it well, you could always expand in the future.

 

[st2205]

Three days should get you in the ballpark of $150k.

 

[ProteusM]

Thanks for the input!

Private practice probably wouldn't be feasible, but locums might work out.

I hear of people who have multiple gigs and sometimes doing a few days in one practice and couple days at another clinic. I guess my goal would be to just to do one part-time gig instead of multiple. The practical obstacle I foresee is how do I get a reasonable deal on office space/secretarial support(if any) for a 3 days/week clinic? I guess ideally if there were someone who wanted to pick up the other two days that would be great. Otherwise maybe I'd just be eating the cost of the other two days?

 

[Shikima]

if you run a practice and work three 8 to 10 hour days a week seeing all pts with good private insurance u could easily make over 500k a year

Ummm, no. 40-45 hrs a week will do that.

 

[ProteusM]

Haha I see some of the revenue estimates posted on here and it makes me feel ambitious. If I could make 200k working 3 days a week that would be absurd and I would be ecstatic. Somehow I'm not overly optimistic about that. But I'm ok with lower income.

 

[F0nzie]

I think 2-3 days a week of patient encounters is the sweet spot in psych. Any more and I am mentally drained... plus the IRS takes a bigger cut.


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[nexus73]

Does anyone have examples of working, say, 4 days a week, 30 hours total, and getting full time status/benefits from a non-profit employer. Asking in regards to both the need for medical benefits and possibility of PSLF.

 

[J ROD]

telepsych from home

 

[PistolPete]

Haha I see some of the revenue estimates posted on here and it makes me feel ambitious. If I could make 200k working 3 days a week that would be absurd and I would be ecstatic. Somehow I'm not overly optimistic about that. But I'm ok with lower income.

Working 3 days a week, 8-10 hours per day, in a cash-pay private practice should net you at least 250k if overhead is low. Probably closer to 300k.

 

[PistolPete]

Does anyone have examples of working, say, 4 days a week, 30 hours total, and getting full time status/benefits from a non-profit employer. Asking in regards to both the need for medical benefits and possibility of PSLF.

I know the State Hospital system and VA can often structure your days as four 10 hour days per week. That's 40 hours per week, not 30, but still full benefits and only a 4 days work week.

 

[ProteusM]

Working 3 days a week, 8-10 hours per day, in a cash-pay private practice should net you at least 250k if overhead is low. Probably closer to 300k.

What about with accepting one big insurance plan?

 

[PistolPete]

What about with accepting one big insurance plan?

Depends on which one you pick and how much they pay and what area you're in, but it should be fairly comparable, maybe a bit less. If you bill most appointments at 99213+90833 for 30 minutes, that should come out to about $250-300 per hour. Then subtract a percentage for no-shows, overhead, and with insurance, a certain amount that won't be paid or will be paid less than what you expect (because, hey, it's insurance).

You can check Medicare rates here, and private insurances should be comparable.
https://www.cms.gov/apps/physician-fee-schedule/overview.aspx

My area is $76 + $68 = $144 for the above codes

 

[ProteusM]

You can check Medicare rates here, and private insurances should be comparable.
https://www.cms.gov/apps/physician-fee-schedule/overview.aspx

My area is $76 + $68 = $144 for the above codes

This is very helpful thanks! I didn't know that you can get the full value of the therapy code in addition to the med management code. For some reason I thought the add-on therapy reimbursement was less? Thanks.

 

[ProteusM]

From what I'm reading 90833 is the therapy add on code, and 90832 is the standalone therapy code. But 90833 pays slightly better! That's counterintuitive to me.

 

[PistolPete]

From what I'm reading 90833 is the therapy add on code, and 90832 is the standalone therapy code. But 90833 pays slightly better! That's counterintuitive to me.

Stand-alone therapy codes are used if you are ONLY doing therapy and no medical decision-making is taking place. This could include psychiatrists, psychologits, MFT's, MSW's, etc.
Add-on therapy codes are added-on to E&M codes which are only used by psychiatrists.

 

[Merovinge]

Depends on which one you pick and how much they pay and what area you're in, but it should be fairly comparable, maybe a bit less. If you bill most appointments at 99213+90833 for 30 minutes, that should come out to about $250-300 per hour. Then subtract a percentage for no-shows, overhead, and with insurance, a certain amount that won't be paid or will be paid less than what you expect (because, hey, it's insurance).

You can check Medicare rates here, and private insurances should be comparable.
https://www.cms.gov/apps/physician-fee-schedule/overview.aspx

My area is $76 + $68 = $144 for the above codes

And that is much lower than BC PPO where I live which is still a bit variable but just above $200 on average for 99213 +90833 so a bit over $400/hour but standard caveat of no-shows, overhead, etc. Plus the difficulty packing a day with 14 or so of those patients 3 days/week.

 

[DetectiveAlonzo]

and cue...

****ty mental health care in 5....4....3......

 

[daru1]

3 days per week in private practice taking one good-paying insurance in many regions of the country will get you >150k easily. Like has been said, save the overhead and do the clerical work yourself. Get a good accountant to help you out. I'm at 3 days per week in my private practice only, and it's going very well.

 

[Dr1216]

Does anyone have examples of working, say, 4 days a week, 30 hours total, and getting full time status/benefits from a non-profit employer. Asking in regards to both the need for medical benefits and possibility of PSLF.

My colleague at my office works 34 hours (4 days) which is the minimum amount of hours that qualifies as full time where we are. They receive full benefits and are also signed up for PSLF. Salary around 170-175k.

 

[ProteusM]

3 days per week in private practice taking one good-paying insurance in many regions of the country will get you >150k easily. Like has been said, save the overhead and do the clerical work yourself. Get a good accountant to help you out. I'm at 3 days per week in my private practice only, and it's going very well.

Very nice! Care to share what your path was to PP? Did you start straight after residency or work for a bit? How do you manage scheduling and billing? You do it yourself? When? Care to share how well it's going?

 

[PistolPete]

3 days per week in private practice taking one good-paying insurance in many regions of the country will get you >150k easily. Like has been said, save the overhead and do the clerical work yourself. Get a good accountant to help you out. I'm at 3 days per week in my private practice only, and it's going very well.

How long did it take you to fill up 3 days a week?

 

[Trismegistus4]

Depending on where you live, locum tenens could be the easiest way to do this. The lowest hourly rate I earned doing locums was $130, the highest was $168, and I received offers of up to $200 (but by then I wanted a permanent job.) Working 24 hours a week, assuming you work 48 weeks per year, those would come out to $149k, $193k, and $230k respectively, with no concerns about billing or office space. Though the availability of part-time work would depend on your locale.

 

[Merovinge]

Depending on where you live, locum tenens could be the easiest way to do this. The lowest hourly rate I earned doing locums was $130, the highest was $168, and I received offers of up to $200 (but by then I wanted a permanent job.) Working 24 hours a week, assuming you work 48 weeks per year, those would come out to $149k, $193k, and $230k respectively, with no concerns about billing or office space. Though the availability of part-time work would depend on your locale.

With telepsych coming in around $150-160 (at least around me) via 1099, it's pretty easy to get the exact (or near exact) hours one wants if you know far enough ahead of time and hunt it down.

 

[TexasPhysician]

And that is much lower than BC PPO where I live which is still a bit variable but just above $200 on average for 99213 +90833 so a bit over $400/hour but standard caveat of no-shows, overhead, etc. Plus the difficulty packing a day with 14 or so of those patients 3 days/week.

That is an incredible rate. I went cash-only partly because 99213+90833 was about $100 in my area.

 

[PistolPete]

That is an incredible rate. I went cash-only partly because 99213+90833 was about $100 in my area.

Damn, that's a terrible rate.