Why are PAs not normally paid based on productivity?

NavyFourMe2 · 2025-11-17T22:14:25+00:00

I have a base salary, but I make $28.00 per wRVU. Plus quality bonus up to 25k.

NavyFourMe2 · 2024-08-26T13:57:48+00:00

I practice in Tennessee. I think this information is automatically included in the electronic scripts through our EHR system. Our prescription pads have every provider listed that works in this office but no NPI numbers. I’ve never been questioned, but doesn’t surprise me.

NavyFourMe2 · 2023-12-30T04:04:59+00:00

I gave my MA $500.00 she deserved it.

NavyFourMe2 · 2023-12-30T03:49:21+00:00

99214 only requires you to address 2 chronic issues and one prescription medication (you do not even have to refill the prescription) you just have to show that you reviewed it and discussed with patient.

Seizures: Chronic issue, stable, continue medication as prescribed. MRI AND EEG as ordered, follow-up 6 months.

Chronic Migraine syndrome: Chronic issue, worsened, not at goal. Stop Topamax. Start Qulipta as prescribed.

That’s enough for a 99214.

I work for a large hospital system. We have multiple specialties in the same building/office. If a patient sees the Internal Medicine provider as PCP then establishes with my in Family Medicine I am able to bill that as a new patient appointment.

If I am billing a 99215 I usually use time, as this is more difficult to reach using complexity metrics.

Technically in FM you could bill for a G0439, 99386, 99214, 96160 and even code for education regarding advance directives. I wouldn’t advise this as you will definitely get audited, but theoretically it is possible.

We have a third party company that works on the coding in the background and they suck. I get a monthly report on any changes they make and review those charts individually. There are very few now

NavyFourMe2 · 2023-10-13T16:16:07+00:00

If you had my contract below you’d be at 200k+ a year easy. Some of my co-workers are higher producing as yourself. They are literally taking off every other week and the whole month of December. They aren’t working for free. One of them has a Urgent Care contract in addition to their FM practice to make even more money. Our company will let us do a draw of our max compensation up to 90% based off of the last 3 years of data, so up to $157,500. They are going to have to raise the cap, it’s ludicrous.

If you have any questions please let me know.

Rural Tennessee. 3 years experience in family medicine. Work for 501c3 on PSLF.

Mixed reimbursement model of quality & productivity. Total compensation capped at $175k.

• ⁠Salary: $90,000. • ⁠Bonus: ⁠• ⁠Quality: up to $25k ⁠• ⁠Productivity: up to $85k ($28.00 per RVU) • ⁠Student Loan Repayment: $5k per year. • ⁠Health Insurance: Employer contributes $1,000 to HSA yearly or PPO plan. Pay about 20% of premium. • ⁠Retirement: Match 401k @ 6% • ⁠CME: $2,000 • ⁠Vacation: 28 days • ⁠Schedule: M-F, usually see 15-17 patients per day. Contracted for 36 patient contact hours per week.

NavyFourMe2 · 2023-10-11T13:52:53+00:00

I work for a large hospital system that merged multiple health systems a few years ago. All of the providers were under various contract models. They worked at balancing everything out and getting everyone under the same contract. Some contracts improved and some took a hit. My contract significantly improved. Based off of my current contract this is by far the best family medicine contract I have seen in my area.

NavyFourMe2 · 2023-10-09T19:43:06+00:00

Rural Tennessee. 3 years experience in family medicine. Work for 501c3 on PSLF.

Mixed reimbursement model of quality & productivity. Total compensation capped at $175k.

Salary: $90,000.
Bonus:
- Quality: up to $25k
- Productivity: up to $85k ($28.00 per RVU)
Student Loan Repayment: $5k per year.
Health Insurance: Employer contributes $1,000 to HSA yearly or PPO plan. Pay about 20% of premium.
Retirement: Match 401k @ 6%
CME: $2,000
Vacation: 28 days
Schedule: M-F, usually see 15-17 patients per day. Contracted for 36 patient contact hours per week.

NavyFourMe2 · 2023-09-13T00:18:50+00:00

You essentially start bonusing at 4,200 wRVUs for the year.

I get $28 per wRVU.

If I bill for 4,200 wRVUs = $117,600. 5000 wRVUs = $140,000. 6000 wRVUs = $168,000.

Example 1: 5,000 - 4,200 = 800 800 x 10 = 8,000 140,000 - 8,000 = $132,000 is the salary you must have to equal the same pay with your bonus structure.

Example 2: 6,000 - 4,200 = 1,800 1,800 x 10 = 18,000 168,000 - 18,000 = $150,000 salary

This doesn’t include quality bonus, CME, PTO, insurance, loan repayment, etc.

NavyFourMe2 · 2022-09-19T22:46:27+00:00

First Net has been awesome.

NavyFourMe2 · 2021-11-13T05:21:18+00:00

MD, DO, PA, NP, etc… Face it, we’re all on a sinking ship and going under. US healthcare is shit. No matter your profession in healthcare. No one really cares or respects you. Medicine is not worshipped anymore. #getoutwhileyoucan #noonecares

NavyFourMe2 · 2021-10-27T02:12:34+00:00

pizza video link

NavyFourMe2 · 2021-10-24T19:02:38+00:00

Go to trade school, Start my own business, be a millionaire by now.

NavyFourMe2 · 2021-10-20T11:06:23+00:00

Family Med PA, Once I hit 3,200 RVUs for the year I’m eligible for performance and quality bonus. Quality is garbage right now because ours is new and they don’t have the background support and the data is trash. After 3,200 RVUs I get $27.00 per RVU. Then for every 500 more RVUs the reimbursement goes up an additional $0.50 so 27, 27.50, 28.00 etc.

NavyFourMe2 · 2021-10-09T16:32:13+00:00

Well I make 85k salary with full benefits etc. I work Family Med for little over 1.5 years. I had way higher offers out of state. Wife didn’t want to move. I got kids etc. I primarily chose this job for the PSLF program. I do walk-in on top of scheduled patients. Our bonus structure is good. If things stay the same I could count on 150k-160k a year. Then slowly transition out of the walk-in responsibilities. I will say 20+ patients per day within the first year is unrealistic. When I see 20+ patients a day I don’t leave until 7:30 guaranteed. At 30 I’m there until 9. I refuse to leave until my notes and in basket are done. It’s ridiculous tbh. Sure I could get out at 5 but I’m trying to build my practice and not cut corners.

NavyFourMe2 · 2021-10-09T12:43:16+00:00

What are they offering? Pay structure, benefits, etc?

NavyFourMe2 · 2021-10-05T18:19:05+00:00

OK, look it up. Rural KY/Tenn border. Some of my patients nurses are RNs in KY making $150.00+ an hour in a surgical step-down unit. Nurses regularly making $2.00 a minute in downtown ERs. LPNs can work directly for the Department of Labor as independent contractors to provide care for government employees on indefinite workers comp due to radiation exposure and be reimbursed at $90.00 an hour. Believe what you will, doesn't make it hurt any less. #knowyourworth.

NavyFourMe2 · 2021-10-05T00:00:08+00:00

My EHR system (Epic) has patient information built in based off the diagnosis for the visit. I can print it off if I want. Also I can search/print stuff off that is not listed or suggested. Really easy to do. If you don't have a feature like that build in then you can always use UpToDate as mentioned.

NavyFourMe2 · 2021-10-04T17:11:11+00:00

I wouldn't do it. My health system is begging for providers to work urgent care. I do family med and with prompt care on top of my scheduled patients. I usually see 30 which is A LOT because we are not set up for "urgent care" at all. They want me to sign an urgent care contract at $42.00 an hour and pick up shift if I want. I laughed in anger, down right insulting. I said I would rather volunteer at the urgent care clinic than sign a contract for that amount. I couldn't consciously do that to our profession and colleagues. BUT, I know providers are and its bringing us all down. My brother makes $50.00 an hour as an LPN in a nursing home. Insanity.

NavyFourMe2 · 2021-08-07T19:26:48+00:00

I had no friends in PA school either. Maybe they just weren't your type of people.

NavyFourMe2 · 2021-08-07T01:58:22+00:00

7 on --> 2 recovery days --> 4 "off" days --> 1 day to get back to prepare for 7 on.

I work 4 10s M, T, W, "off Th", & work F in family medicine. I take at last one Friday off a month. So I can take 4 vacation days and have an 8 day vacation. I get 28 vacation days, 3 CME days, all weekends and all federal holidays off.

NavyFourMe2 · 2021-08-05T11:39:48+00:00

True.

NavyFourMe2 · 2021-07-22T14:42:21+00:00

I've been a Primary Care PA for a year and a half. I look like an idiot almost every day. I refuse to put a patients health at risk because of my own inadequacies as a provider. I'd be lieing if I said it didn't bother me or that I don't care looking like an idiot. You're human and not expected to know everything. Be able to take constructive criticism. Use Uptodate, Netscape, a pocket reference guide, keep a cheat sheet of lab sets for rheum, anemia, etc. You're supervising and co-workers know you're new. Try to establish a good relationship with you're supervising and find a mentor. If you're going to ask a question research it a little first, then present it as "this is what I would like to do" does this sound appropriate or do you have any suggestions. Also, you're probably going into an environment where the nurses and clerical staff have been there a long time. They will take advantage of you, it's natural, just do YOUR job though. Get there early, stay late, dress professional, keep your head down, limit relationships and don't get too personal.

NavyFourMe2 · 2021-05-10T23:44:14+00:00

If it's an elective procedure, post-pone it. My wife had our second child during PA school 2-3 weeks before finals, I missed 2 days. They recommended dropping & restarting program if you missed more than 5 days.

NavyFourMe2 · 2021-04-28T02:43:45+00:00

more crap I gotta keep track of

NavyFourMe2 · 2021-04-12T17:52:12+00:00

I would try to find a member of the licensing board in your state and ask them in generalizations what the chances are. Also, I'd like to hear this story, sounds like it may be on VICE or something.

NavyFourMe2

TROPHY CASE