Pay for NP Independent Contractors

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    Does anyone have any idea how much a nurse practitioner should be paid for home visits? I had a doctor offer me $25 per visit (plus gas). After speaking with a home health RN, I discovered that she gets paid $40 per visit! Obviously, I can't accept such low pay, considering my education, responsibilities and liability. Does anyone have any idea how much I can expect?

    I get paid $50/hour in urgent care (no benefits). I've also been paid $20 per patient in a primary care setting (minimum 20 pts per day). I would expect the pay for home health visits to be much higher.
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    So would I Brandy. Hopefully someone more familiar with this area of APN jobs will come along soon. $25 is pathetic!
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    I am very interested to see what independent contractor NPs have to say about this. Fascinating topic!

    In the meantime, I just wanted to say sometimes these types of questions can be clarified by framing them in different ways. For example...

    You mentioned you made $20 per patient in primary care. How many pts did you see per hour? 4? 5? Let's lowball it and say 4. That's $80 per hour. How many homecare pts can you see in an hour? 1? Less than 1? For ease of calculation, let's say you can see 1 pt per hour. Well, then you should be paid around $80 per patient to keep pace with what you made in primary care.

    Another way to frame this: How much does the dr bill for your service per homecare pt? You should receive a high percentage of that amount, plus gas.

    I can tell you this: as a freelance writer (transitioning to nursing), I've participated in many conversations about how to price our services. The bottom line has always been that $50 per hour is minimum subsistence level for an independent contractor because you have to pay for your own benefits, along with withholding, Social Security, etc., which all require additional administrative time to deal with. Something for you to consider, anyway.
  7. 0
    Quote from semisweetchick

    You mentioned you made $20 per patient in primary care. How many pts did you see per hour? 4? 5? Let's lowball it and say 4. That's $80 per hour. How many homecare pts can you see in an hour? 1? Less than 1? For ease of calculation, let's say you can see 1 pt per hour. Well, then you should be paid around $80 per patient to keep pace with what you made in primary care.

    Another way to frame this: How much does the dr bill for your service per homecare pt? You should receive a high percentage of that amount, plus gas.
    I could easily see 4 pts per hour in primary care, but they usually limited me to 25 per day (although one day I saw 48!). I need to find out how much the doctor is going to bill for the service (Medicare reimburses 92% of the doctors rate for a midlevel), of course, that's not what he will collect. I'm going to have to consider driving time, safety issues (home health can be unsafe), etc.
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    You work in a doctor's office and make 2500 a week as an NP?

    I figured 20 X 25 = 500 per day at 5 days a week is 2500. Is that with benefits? How much experience?
    That's about $96,000 a year.
    I didn't know NP went that high.
  9. 0
    Quote from CRNASOMEDAY25
    You work in a doctor's office and make 2500 a week as an NP?

    I figured 20 X 25 = 500 per day at 5 days a week is 2500. Is that with benefits? How much experience?
    That's about $96,000 a year.
    I didn't know NP went that high.
    I currently work PRN at 3 urgent care clinics and they pay midlevels $50 per hour. When I worked PRN in primary care, I was paid $20 per patient. None of these jobs pay benefits and there wasn't/isn't a guarantee on how many hours you get per week. If I take vacation or sick leave, then I don't get a dime. I've been working as an independent NP for almost 2 years now and so far it has paid off. The majority of NP's who work fulltime with full benefits probably average around 75K per year. In the end, we probably make around the same amount of money. I prefer contract work, because I don't feel like I have to get involved in office politics plus I love diversity.
  10. 0
    Quote from BrandyNP
    I could easily see 4 pts per hour in primary care, but they usually limited me to 25 per day (although one day I saw 48!). I need to find out how much the doctor is going to bill for the service (Medicare reimburses 92% of the doctors rate for a midlevel), of course, that's not what he will collect. I'm going to have to consider driving time, safety issues (home health can be unsafe), etc.
    I work in specialty care so we don't see as many patients per hour. I wonder how you can see 48 patients in a day and do a good job. For the homecare the reimbursements are significantly better. A 99212 in a office setting (straight forward problem) will pay $22 for an established patient. This same visit for a home visit will pay $73. Now remember that you will be seeing less patients because of travel time but they should be more complex because of the necessity to see them at home. Sounds like $20 per patients wouldn't make it. Also the NP medicare rate is 85% not 92%. There are significant geographical differences that may make this more or less.

    Look at these articles: Medscape needs registration

    Specifically on APN's doing home visits.
    Log In Problems

    ACP article that has some importand information:
    ACP Observer, December 2006 - Defining home visits, and how location affects payments

    and finally the American Academy of Home Care Physicians that has good info:

    American Academy of Home Care Physicians - Info for Home Care Professional and Health Care Providers: FAQ

    David Carpenter, PA-C
  11. 0
    Quote from core0
    I work in specialty care so we don't see as many patients per hour. I wonder how you can see 48 patients in a day and do a good job. For the homecare the reimbursements are significantly better. A 99212 in a office setting (straight forward problem) will pay $22 for an established patient. This same visit for a home visit will pay $73. Now remember that you will be seeing less patients because of travel time but they should be more complex because of the necessity to see them at home. Sounds like $20 per patients wouldn't make it. Also the NP medicare rate is 85% not 92%. There are significant geographical differences that may make this more or less.

    Look at these articles: Medscape needs registration

    Specifically on APN's doing home visits.
    Log In Problems

    ACP article that has some importand information:
    ACP Observer, December 2006 - Defining home visits, and how location affects payments

    and finally the American Academy of Home Care Physicians that has good info:

    American Academy of Home Care Physicians - Info for Home Care Professional and Health Care Providers: FAQ

    David Carpenter, PA-C
    Thanks for the information. As far as seeing 48 patients, I started at 7am and worked until 6:30 pm (no lunch or breaks). I usually only saw 20-25 pts per day, due to the fact that I was being paid per patient. On the other hand, the fulltime midlevel had to see 30-35 pts per day, because she was salary.
  12. 0
    Quote from CRNASOMEDAY25
    You work in a doctor's office and make 2500 a week as an NP?

    I figured 20 X 25 = 500 per day at 5 days a week is 2500. Is that with benefits? How much experience?
    That's about $96,000 a year.
    I didn't know NP went that high.
    I used to see 60-70 weight loss patients on the busy days and averaged 40 per day throughout the year and got $20/pt. Yes, that's nearly $200K per year as a lowly NP. Hard to believe, eh? What's even crazier is I left! Why? Money isn't everything....


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