Private Practice Question

[PGY2]

For all of you in private practice, I want to ask a question. With all the doom and gloom talk about reimbursement, which of the following is the best setup for a new private practice in the long run:

1) Completely self contained office which has a procedure room and C-arm for all basic injections

2) Office w/o procedure room, doing all fluoro requiring procedures at a surgery center that you have an ownership interest in

Thanks in advance.

PGY-2 (not really, have been out of residency and fellowship for 3 years).

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[Disciple]

Reimbursement for #2 is dropping.

#1 could drop at any time.

 

[PMR 4 MSK]

#1 has huge set-up costs, unless you lease, then it's just big set-up costs. I did #1. I made a lot more on the procedures, only due to the TC on the fluoro - whoever owns the fluoro gets the money, and it's often 3 - 4 x PC.

I now do #2, without the owndership interest. For some procedures in medicare, I get less than $100 for the whole thing. In your own office, you can do much better than that.

In addition, the precert process is much easier and scheduling far easier if it's in your office.

 

[PGY2]

When doing fluoro procedures in your office, does your office need to be credentialed with the payor as a separate entity to bill for the supplies and fluoro time? Or are you just paid one global fee for supplying everything?

Thanks again in advance.

 

[PMR 4 MSK]

When doing fluoro procedures in your office, does your office need to be credentialed with the payor as a separate entity to bill for the supplies and fluoro time? Or are you just paid one global fee for supplying everything?

Thanks again in advance.

No, same entity. You bill the procedure and the fluoro (TC and PC) and the injectate. Supplies, like needles and syringes are bundled with the procedure and not billed seperately.

 

[stim111]

I work in an ASC without ownership. My reimbursement is not much in this case. You can do better if you can lease back the space and then get the office based rate for these days.