TFESI reimbursement Q: ASC vs in office

[paindoc34]

Can someone give me a general idea of how much a two level TFESI reimburses in the office versus an ASC (just pro fee). I have no stake in the ASC but needed to do procedures there for patients in a certain location. Got my check from there bundled for a few procedures and it is lower than I thought it would be. Also is there a resource to find this information for other procedures? Just want to make sure I'm being reimbursed fairly.

Thank you!

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[Taus]

Can someone give me a general idea of how much a two level TFESI reimburses in the office versus an ASC (just pro fee). I have no stake in the ASC but needed to do procedures there for patients in a certain location. Got my check from there bundled for a few procedures and it is lower than I thought it would be. Also is there a resource to find this information for other procedures? Just want to make sure I'm being reimbursed fairly.

Thank you!

Google asipp fee schedule. You will make in general 1/3 to 1/2 at an asc compared to office

 

[BobBarker]

It is around 1/3 in my area.

 

[SC Tian]

 

[SC Tian]

They are old ones, you get about 1/2, however you do not need to pay overhead of office procedures including xray staff, injection tray and Injection material, they can be costly depending on your efficiency of office procedures.

 

[BobBarker]

I got $89 for an epidural I did at the hospital. Try to avoid using a facility for injections.

 

[bedrock]

Can someone give me a general idea of how much a two level TFESI reimburses in the office versus an ASC (just pro fee). I have no stake in the ASC but needed to do procedures there for patients in a certain location. Got my check from there bundled for a few procedures and it is lower than I thought it would be. Also is there a resource to find this information for other procedures? Just want to make sure I'm being reimbursed fairly.

Thank you!

Patients need to travel a bit or you’re getting screwed. If you go to their area for clinic visits, they can come to your area for procedures.

You make procedure $$ in one of three ways in pain medicine (unless you own the whole practice)
1- do all procedures in your office procedure room
2- do procedures at hospital which employs u
3- do ASC procedures in an ASC in which you have a significant amount of shares.

 

[SC Tian]

Imo, office procedure can be more beneficial if you can lower your office procedure overhead to 50% of revenue, even not taking into account initial investments in your procedure room renovation, C arm, and procedure bed.
I am aware of some private practice models, pain docs only get 50% of professional revenue in ASC and 50% of revenue in office. they can be very profitable if they work at an efficient ASC. To simply understand the procedures in ASC, it is probably equivalent to $60-70 per wrvu.

 

[lobelsteve]

I got $89 for an epidural I did at the hospital. Try to avoid using a facility for injections.

Beat me. I got an rvu or 2.

 

[BobBarker]

You got probably 1.8 wRVU.

 

[SC Tian]

Here I received $99 for interlaminar epidural equivalent to 1.1 wrvu.

 

[drusso]

Here I received $99 for interlaminar epidural equivalent to 1.1 wrvu.

We had to have a plumber come and fix our toilet that was leaking at the base. It was $400 and it took her 10 minutes. How many RVU's is that?

 

[SC Tian]

We had to have a plumber come and fix our toilet that was leaking at the base. It was $400 and it took her 10 minutes. How many RVU's is that?

Good point, our practice own an free-standing asc, i review the revenue every month, pain injection is comparable to hand surgery or slightly better, however there are 2 pain interventionsts in our practice who changed back to office injection even he had shares in asc. In another word, it is correct $400 for interlaminar facility, there are 1 rn in prep-holding, one rn in procedure rm, one staff and X-ray tech in rm, one rn on PACU, the cost is almost 1000 a hour, it all depends on how your practice is able to increase efficiency and to reduce the cost. Just my observation.

 

[RoloTomassi]

there are 1 rn in prep-holding, one rn in procedure rm, one staff and X-ray tech in rm, one rn on PACU, the cost is almost 1000 a hour

Damn I should've been an RN

 

[BobBarker]

Lumbar RFA bilateral around $300 hospital, around $1000 office

 

[SC Tian]

For high facility fee procedures such as stim and kypho, there are huge difference between office and asc, if no shares in asc, they should be done in office, for kypho it is just unreal, I guess ppl really satisfied with the profits if they have done kyphos in office.

 

[geauxg8rs]

I got $89 for an epidural I did at the hospital. Try to avoid using a facility for injections.

Steak dinner at Texas Roadhouse but no dessert

 

[Ducttape]

Imo, office procedure can be more beneficial if you can lower your office procedure overhead to 50% of revenue, even not taking into account initial investments in your procedure room renovation, C arm, and procedure bed.
I am aware of some private practice models, pain docs only get 50% of professional revenue in ASC and 50% of revenue in office. they can be very profitable if they work at an efficient ASC. To simply understand the procedures in ASC, it is probably equivalent to $60-70 per wrvu.

um...

pain docs should get 100% professional fees.

not sure where you are getting that information, but there are separate facility fees for the ASC. the ASC should never have access to your professional fees, and it is supposed to be billed separately.

 

[SC Tian]

um...

pain docs should get 100% professional fees.

not sure where you are getting that information, but there are separate facility fees for the ASC. the ASC should never have access to your professional fees, and it is supposed to be billed separately.

It is a model of largest pain practice in Wisconsin, the group provides you everything including office, asc, supporting staff and billing, you get 50% professional fees, sounds absurd, but it is true, my friend. There are so many ways of pain practice, this overall is not bad.

 

[BobBarker]

50% pro fee on office procedures is a good deal if you are going into an existing well run office.

50% pro fee for ASC work in an ASC run by your senior partners isn’t that good, but if you are just doing implants there nothing to get worked up over. It makes the math confusing to change it for ASC vs office and might not be fully legal as the physician practice and the ASC are different businesses.

 

[Ducttape]

now see what you are stating is different. you are talking about an employed model, for which they doctors are salaried and are paid by a different entity.

if you are not salaried/employed, then you get 100% of the professional fees.

 

[SC Tian]

now see what you are stating is different. you are talking about an employed model, for which they doctors are salaried and are paid by a different entity.

if you are not salaried/employed, then you get 100% of the professional fees.

they are not employed and salaried either, they are called partners just limited. However you cann't make a living with medicare patients, with good payor mixture, because they are so efficient, top player can make toward 1 m.

 

[SC Tian]

50% pro fee on office procedures is a good deal if you are going into an existing well run office.

50% pro fee for ASC work in an ASC run by your senior partners isn’t that good, but if you are just doing implants there nothing to get worked up over. It makes the math confusing to change it for ASC vs office and might not be fully legal as the physician practice and the ASC are different businesses.

there are some legal concerns if you run both clinic and ASC at the same time, there are always ways to work around them, they have two separate companies, but to my knowledge, they are common practices that may provide more protection.