PsychNP's- Salary Negotiation Thoughts & Pearls

[PMHNP2B]

Hello All:

I am new to the board. I will be completing my PMHNP program this spring. I am about to enter into contract negotiations. I am unsure about a few things and thought I would ask those of you have completed this process if you have any thoughts or pearls of wisdom to share.

An office that I have been completing clinicals at is interested in having me join them after I complete my degree. This is a wonderful, well-regarded mental health practice in our community and I can't think of a better practice to join. I would essentially be entering into (group) private practice. They are insurance/cash only - no medicare/medicaid. As far as working environment goes, this is my dream facility and dream people to work with. I live in a rural area in the west; population ~60,000 with a population draw area >200,000 people.

They have asked me to put together a proposal. However:

1. I am having a hard time determining what is too little and what is too much to ask for.

2. I will not be provided benefits until I reach a F/T salaried status.

3. I will be the ONLY PMHNP in our area.

4. This area has a shortage of mental health prescribers - there are only 6-7 psychiatrists in this area. These psychiatrists are not affiliated with the organization I would join.

5. I will (essentially) be the only prescriptive/medical provider at this facility. Should I be concerned about this - or overjoyed?

6. Their preference is that I start out on a 'x" reimbursement basis and, when my practice builds to transition to a salary. X reimbursement could be: % of billings, or a higher % of collected receipts, or to determine a 'patient hour' reimbursement rate.

7. Based on my calculations, my "average" hour of work with (using a composite of visit types and figures provided from insurance contract amounts) is about $200/hr.

Questions:

A) What are any of your initial thoughts?

B) What do you all feel is a better reimbursement schedule: % of billings, % of receipts, or an hourly rate?

C) If my billable hour is roughly worth $200 - what is fair/reasonable to ask for?

I think it is difficult to find accurate PMHNP salary data. The few sources I have found (payscale.com, salary.com) do not seem accurate to me. If they are - as PMHNP's we are getting screwed - the estimates at those sites range from 73K-97K. I feel that is too low. I think a reasonable salary expectation is 120K-140K. Am I off-base?

What have you guys found in your career? Any salary pearls of widsom?

Thanks in advance.

PMHNP2B

[mania4real]

Wow, this is discouraging, thought PMHNPs is about the second highest paid advanced nursing practice.

[PMHNP2B]

Wow, this is an old question I posted several years ago. Mania4real, I thought I would respond and update. I joined the organization I mentioned in the opening post. To summarize, it is a counseling clinic that see insurance and cash only, medicare/medicaid. I am the only medical provider (my state allows for independent practice). I am paid on an hourly basis, $90.00 per hour, except for my intakes. I decided I prefer to conduct a 90 minute intake, as opposed to an hour, and I get paid $90 for the intake (as opposed to say $135). My follow up appointments are 30 minutes. I actually "see patients" for 23 hours of the week, but with administrative work and such, I probably work a total 27-30 hours per week. (30 is a bad week). I have no benefits whatsoever, but I get $90 an hour, set my own schedule, take off what I want to take off, and that sort of autonomy is worth it to me. 11 months into the year, working roughly 27 hours per week, and pretax I have earned 75K, and post tax have brought home 60k. That's not very much BUT I choose not to work very much because I value quality of life. I could work more and earn more but I would become very grumpy and what's the point of working more to have a "better" life that you are miserable living?

[harmonizer]

I have heard the same thing, the salaries mention in the above posting seem really low. the PMHNP that I know all make 6 figures.

I know PMHNP who earns less than six fig in "salary". But let me tell us this..the salary varies so much based on geographic position. Reimbursement is not any more and sometimes less than any other specialties. What drives up the pay in some areas is only supply and demand. So basically, it depends on what the market can bear. I do not have crystal ball to see the future but with more grads and schools now, salary may decrease without no change in reimbursement rate.

[mania4real]

Hi harmonizer, thanks for your insight, it was really helpful.

[puravidaLV]

I won't be graduating for a while and I live in a large city yet geographically defined by mountains and not much else beyond them. Two doctors in private have offered 140-160 to start while at the veterns hospital I've been told 85k. This is all based on pmhnp degree I haven't even earned yet. A lot of it might be networking as well. I tend to fix Porsches when I am off

[Jules A, MSN]

I won't be graduating for a while and I live in a large city yet geographically defined by mountains and not much else beyond them. Two doctors in private have offered 140-160 to start while at the veterns hospital I've been told 85k. This is all based on pmhnp degree I haven't even earned yet. A lot of it might be networking as well. I tend to fix Porsches when I am off

For some reason the VA hasn't caught up to the standard in my area with regard to Psych-NPs. As of a few years ago their highest rate, for like 20 years experience, was $50,000 less per year than my first NP job as a new grad.

[puravidaLV]

I am on the fence now since I just turned in my E-quip stuff for the VA and if the salary for psych floor nurse isn't what I want it to be I'll stay where I am at. Moving from 12 to 8 hour shifts for the same pay with little to no overtime doesn't seem worth much.

I keep getting told there are amazing benefits at the VA, yet looking at their recruitment website and comparing them to the state prisons I see noooothing that special. Lots of older nurses are telling me do it for retirement. I guess at 35 I should think about that instead of my current wallet though....naa #yolo?

[Jules A, MSN]

I am on the fence now since I just turned in my E-quip stuff for the VA and if the salary for psych floor nurse isn't what I want it to be I'll stay where I am at. Moving from 12 to 8 hour shifts for the same pay with little to no overtime doesn't seem worth much.

I keep getting told there are amazing benefits at the VA, yet looking at their recruitment website and comparing them to the state prisons I see noooothing that special. Lots of older nurses are telling me do it for retirement. I guess at 35 I should think about that instead of my current wallet though....naa #yolo?

As a floor nurse I made a very nice, competitive wage it was when they offered me a NP position that it was horrible. I also didn't think the benefits were all that impressive. The time off, if you can get it, holidays and health insurance were very good however their retirement is similar to a 403B. Someone please correct me if I am wrong but the pension has been gone for years. Personally the money I would have lost in my yearly salary far exceeds any benefits they were offering at the time.