Realistically how much revenue is a psychiatrist generating for 99213/14 for commercial and medicare?

[deleted1100659]

Trying to get a good sense of salary negotiating. How much is a psychiatrist typically generating from a mix of 99214/99213 and what average patient loads associated with that? Kind of a broad question, but was curious to input some hypothetical numbers to have a good sense of what amout of money is reasonable to ask for.

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[Psychresy]

Trying to get a good sense of salary negotiating. How much is a psychiatrist typically generating from a mix of 99214/99213 and what average patient loads associated with that? Kind of a broad question, but was curious to input some hypothetical numbers to have a good sense of what amout of money is reasonable to ask for.

In my residency clinic I'll say 85-90% of patients are a 99214. We have a good mix of patients so I'd imagine the "real world" is similar to this sort of ratio as well..might help your calculations assuming a similar ratio.

 

[TexasPhysician]

Trying to get a good sense of salary negotiating. How much is a psychiatrist typically generating from a mix of 99214/99213 and what average patient loads associated with that? Kind of a broad question, but was curious to input some hypothetical numbers to have a good sense of what amout of money is reasonable to ask for.

Too broad to get a good answer.

 

[FlowRate]

With the recent coding changes I agree that probably 90-95% of patients will be 99214. People who track their own billing will know that mix exactly.

Your question really isn't about panel size, it's about schedule. n clinical hours * 2 * (0.9*reimbursement_4+0.1*reimbursement_3) will give you a back of the napkin sense of full schedule steady-state gross billing. Modify as needed for new pt mix/attrition/no-shows.

But if you're just asking about salary in an employed job then that's also dependent on market/location.

 

[calvnandhobbs68]

People often try to ask this question but it's hugely location specific in terms of reimbursement (and even clinic/hospital system specific). For instance, large hospital systems often negotiate better rates for themselves with private insurance just based on market share or can do things like add facility fees to hospital based clinics that private practices can't. E+M reimbursement can also vary like 75%+ based on location (like literally in some places a 99214 pays $100 and in some places pays $175).

So @TexasPhysician is right, too broad for a real answer.

 

[Psychresy]

People often try to ask this question but it's hugely location specific in terms of reimbursement (and even clinic/hospital system specific). For instance, large hospital systems often negotiate better rates for themselves with private insurance just based on market share or can do things like add facility fees to hospital based clinics that private practices can't. E+M reimbursement can also vary like 75%+ based on location (like literally in some places a 99214 pays $100 and in some places pays $175).

So @TexasPhysician is right, too broad for a real answer.

Might be helpful if people put where they were located (as they feel comfortable doing) and their rates. At least we'd be able to see if there were trends in certain regions. Though I know it can vary even based on the block you're on.

 

[Sushirolls]

People often try to ask this question but it's hugely location specific in terms of reimbursement (and even clinic/hospital system specific). For instance, large hospital systems often negotiate better rates for themselves with private insurance just based on market share or can do things like add facility fees to hospital based clinics that private practices can't. E+M reimbursement can also vary like 75%+ based on location (like literally in some places a 99214 pays $100 and in some places pays $175).

So @TexasPhysician is right, too broad for a real answer.

Some places a 99214 pays in excess of $175.

The difference from what was my worst commercial insurance to my best commercial insurance for a 99214 is ~$136

As a patient, I reviewed my old EOBs and the local Big Box shops are getting for non-psych 99214 rates of ~$292 and ~$305

 

[deleted1100659]

Some places a 99214 pays in excess of $175.

The difference from what was my worst commercial insurance to my best commercial insurance for a 99214 is ~$136

As a patient, I reviewed my old EOBs and the local Big Box shops are getting for non-psych 99214 rates of ~$292 and ~$305

Woa, excess of 175? What kind of commercial rates were you typically seeing for a 99214?

 

[Stagg737]

Reimbursement rates may vary, but if you’re billing less than 75% 99214 now you’re almost certainly doing something very wrong. I know 0 people irl who bill less than 85-90% 99214 for f/ups.