Re: fee schedule

[Guest guest]

I would mirror Shane's comments. The Medicare Fee Schedule is not designed

to bring major profitability to a PT in Private Practice. Their fee schedule

is designed to cover the cost of a Medicare Patient (which I think is

debatable). I would encourage you to at least double the Fee Schedule for your

codes.

Jim Hall, CPA <///><

General Manager

Rehab Management Services, LLC

Cedar Rapids, IA

319/447-5625

Visit our Website at:

_http://www.rehabmgmt.com_ (http://www.rehabmgmt.com)

[Guest guest]

Great question! We need to be considering things like this.

Surveying an entire national list serve of 15,000+ therapists does not

qualify as unlawful collaboration, nor price fixing.

Setting charges:

FIRST -- make sure you understand that " what you charge " may have no

relationship at all to " what a payer sends you. " In the healthcare

marketplace, the customers dictate payment. There is no " free market " when

the patient uses an insurance company. That's insane, but it's what we

live with.

1) Cost method: Determine your overall costs, and allocate them down to

each item of service you provide in a pro-rata manner. Adjust annually at

least. It's a lot of work, and may not be worth it.

2) Market survey: Survey payor groups, and set charges to their payment

schedules. Changes are, they will refuse to tell you, since if they did,

that amount would instantly become everyone's minimum charge! They prefer

to wait to get your bill, and then pay what they have decided is

" reasonable " or " usual " among their three favorite providers.

3) Guerrila marketing: Get the local hospital's charge schedule, and set

your charges to be less then theirs, if the charge is favorable to you.

(Don't try to beat the Medicare $13 whirlpool payment!) Do the same with

your local private practice competitors.

The day of " Build it and they will come " is long gone.

Set up your practice to allow you to spend less than you take in. Start

lean. Stay that way. Don't set it up to try to take in what you're

spending, until you have a lot of business acumen.

Make sure that you bill for everything you do, and watch the cash in vs.

cash out like a hawk.

Use an attorney for the legal documents and interpretations -- and to keep

your head clear.

Use an accountant to coach you on finance.

Use a practice consultant to tell you whether your practice idea will work.

Soggy greetings,

Dick Hillyer, PT

Cape Coral, FL

Re: fee schedule

I would mirror Shane's comments. The Medicare Fee Schedule is not designed

to bring major profitability to a PT in Private Practice. Their fee

schedule

is designed to cover the cost of a Medicare Patient (which I think is

debatable). I would encourage you to at least double the Fee Schedule for

your

codes.

Jim Hall, CPA <///><

General Manager

Rehab Management Services, LLC

Cedar Rapids, IA

319/447-5625

Visit our Website at:

_http://www.rehabmgmt.com_ (http://www.rehabmgmt.com)

[Guest guest]

First, the responses were not meant to be harsh on persons,

specifically, but on the concept of soliciting advice on pricing. A

current court case in Delaware accuses specialty providers of

collusion and price fixing... I am as of yet unaware of the specific

letigious terms used. Thus, many of us hesitate to share our info,

if for no other reason but to prevent being named in a class action

law suit.

- Simonetti, PT

> ,

>

> I think that these previous two post have been rather

> harsh on you.

[Guest guest]

--

Ingenix (St. Publishing) publishes a " Customized Fee Schedule " manual

that provides fees in the 50th, 60th, 75th, and 90th percentile for CPT codes by

specialty based on zip code. In addition to the good suggestions offered

regarding determining your cost to deliver the services and using the medicare

fee schedule, this would be a useful tool.

Good luck,

Jon Rose

Clinic

Memphis, TN

fee schedule

I am just starting private practice and would like to know if my fee schedule is

in the right ballpark. Can you share with me what you charge for eval, ther ex,

gait training, manual therapy, neuromuscular re-ed, ther act, e-stim, wound

care, whirlpool (not hubbard)? I am in Indiana.

Thank you,

Killigrew, PT

Integrative Healing

[Guest guest]

Thank you to everyone who has responded to my question about fee schedules.

Another question: I am the only practitioner in my practice. I have a

billing service to bill insurance. What is your opinion on becoming a

participating provider for insurance companies? I am currently not

participating with any insurances. I understand it is a gruelling

experience to go through the process and many times you get paid a whole lot

less. For those who do not participate, do you write off the amount you

don't get from insurance? Since the patient normally has a higher

percentage he has to pay with an out of network provider, I am wondering if

it would be a compromise to keep cost down for the patient and not have to

go through the hassle of becoming a provider.

Thanks again for all of your suggestions.

fee schedule

>

>

>

>

>

> I am just starting private practice and would like to know if my fee

schedule is in the right ballpark. Can you share with me what you charge

for eval, ther ex, gait training, manual therapy, neuromuscular re-ed, ther

act, e-stim, wound care, whirlpool (not hubbard)? I am in Indiana.

>

> Thank you,

> Killigrew, PT

> Integrative Healing

>

>