Pathology: Real 88305 reimbursement down 66% in past 27 years

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

PathDoctor

Membership Revoked
Removed
Joined
Sep 30, 2019
Messages
49
Reaction score
44
2019: 88305 PC CMS reimbursement: $39.64

1992: 88305 PC CMS reimbursement: $63.00
1572035143156.png


U.S. Inflation Rate, $63 in 1992 to 2019
According to the Bureau of Labor Statistics consumer price index, today's prices in 2019 are 83.01% higher than average prices throughout 1992. The dollar experienced an average inflation rate of 2.26% per year during this period, meaning the real value of a dollar decreased.

In other words, $63 in 1992 is equivalent in purchasing power to about $115.29 in 2019, a difference of $52.29 over 27 years.

39.64/115.29= 0.34

So now you basically need to sign out triple the volume of cases to generate the same income as a pathologist in 1992!!! Welcome to the pathology sweatshops!!!

Members don't see this ad.
 
  • Like
  • Angry
Reactions: 1 users
2019: 88305 PC CMS reimbursement: $39.64

1992: 88305 PC CMS reimbursement: $63.00
View attachment 284544

U.S. Inflation Rate, $63 in 1992 to 2019
According to the Bureau of Labor Statistics consumer price index, today's prices in 2019 are 83.01% higher than average prices throughout 1992. The dollar experienced an average inflation rate of 2.26% per year during this period, meaning the real value of a dollar decreased.

In other words, $63 in 1992 is equivalent in purchasing power to about $115.29 in 2019, a difference of $52.29 over 27 years.

39.64/115.29= 0.34

So now you basically need to sign out triple the volume of cases to generate the same income as a pathologist in 1992!!! Welcome to the pathology sweatshops!!!

MPGA!!!!
 
Last edited:
  • Love
Reactions: 1 user
A blind man could see this. I made $700k in 1992 as a P.P. partner, and that was not unusual. I do not believe very many are making 1.3M ( the rough equivalent) today!
And it isn’t going to get better.
 
  • Like
Reactions: 1 user
Members don't see this ad :)
Just wait till you are salaried and payments are bundled. You ain't seen nothing yet.

Youngsters, learn business and get many different sources of income outside of pathology. It is not hard to do and will keep you from spending decades worrying about your job and how you will pay the bills.
 
  • Like
Reactions: 1 user
Just wait till you are salaried and payments are bundled. You ain't seen nothing yet.

Youngsters, learn business and get many different sources of income outside of pathology. It is not hard to do and will keep you from spending decades worrying about your job and how you will pay the bills.

What type of business we talking about which is not hard to do, profitable and worth all the time invested???? I’ve never heard of a worth your time, profitable business which is NOT hard to do.
 
Last edited:
  • Like
Reactions: 1 user
A blind man could see this. I made $700k in 1992 as a P.P. partner, and that was not unusual. I do not believe very many are making 1.3M ( the rough equivalent) today!
And it isn’t going to get better.

M ick Raich, CEO of Vachette Pathology, has been working in health since 1981 and started in pathology billing in 1996. Since launching Vachette Pathology in 2002, he has seen a lot of changes. “I have seen when hospitals first went to DRGs. I watched Detroit go from 31 hospitals to six,” Raich says. The major change he’s seen in pathology is that it is much more competitive and the margins are considerably less than they used to be.

“Salaries for most of our pathologists—and we’ve worked with 10 percent of all pathologists in the nation in the last 17 years—have been in a long, steady decline as pathology groups continue to consolidate. The second major trend is a big change in the ability to negotiate with payers.” The major impact of the national surprise billing laws now evolving will be that they take away the ability to negotiate, Raich says. “The truth is, the ability to negotiate is how we stay in business. If a surprise billing law comes into play and you have to cut the rate and you can’t balance bill patients, as an unintended consequence you are going to drive down provider rates considerably.”

At one time, pathology made up a small percentage of insurance companies’ business, but now pathology and labs are a big percentage and on the radar—but they have lost the ability to negotiate, Raich believes. Over the past three to five years, he says, insurance plans often cut big deals with the large national labs at low rates and have cut other labs out of the formulary. “They’re saying, ‘We don’t even want to work with you. We are paying these guys 40 percent of Medicare. I don’t have to pay you 100 percent of Medicare.’” There is still a perception that doctors make too much money, he says, but in fact pathologists continue to make only 30 cents on the dollars they bill.
 
Last edited:
  • Like
Reactions: 1 user
M ick Raich, CEO of Vachette Pathology, has been working in health since 1981 and started in pathology billing in 1996. Since launching Vachette Pathology in 2002, he has seen a lot of changes. “I have seen when hospitals first went to DRGs. I watched Detroit go from 31 hospitals to six,” Raich says. The major change he’s seen in pathology is that it is much more competitive and the margins are considerably less than they used to be.

“Salaries for most of our pathologists—and we’ve worked with 10 percent of all pathologists in the nation in the last 17 years—have been in a long, steady decline as pathology groups continue to consolidate. The second major trend is a big change in the ability to negotiate with payers.” The major impact of the national surprise billing laws now evolving will be that they take away the ability to negotiate, Raich says. “The truth is, the ability to negotiate is how we stay in business. If a surprise billing law comes into play and you have to cut the rate and you can’t balance bill patients, as an unintended consequence you are going to drive down provider rates considerably.”

At one time, pathology made up a small percentage of insurance companies’ business, but now pathology and labs are a big percentage and on the radar—but they have lost the ability to negotiate, Raich believes. Over the past three to five years, he says, insurance plans often cut big deals with the large national labs at low rates and have cut other labs out of the formulary. “They’re saying, ‘We don’t even want to work with you. We are paying these guys 40 percent of Medicare. I don’t have to pay you 100 percent of Medicare.’” There is still a perception that doctors make too much money, he says, but in fact pathologists continue to make only 30 cents on the dollars they bill.

In my experience, which pre-dates Mick Raich’s by a few years, those comments are just about 100% accurate.
 
  • Like
Reactions: 2 users
Supply and Demand. Too few specimens for too many pathologists. No other explanations! Who here still doesn't get it?
 
  • Like
Reactions: 2 users
Top