medicare reimbursement 85%

platon20 · May 30, 2010

If NPs are being reimbursed 85% of what doctors are for the same care, why do NPs make so much less?? If an average family MD makes $160,000 an average FNP would make $136,000. But... they make $85,000. How does that happen?

Because NPs are less "efficient" than MDs. MDs routinely see 50-60 patients in clinic per day, whereas NPs provide "holistic, patient based care" and therefore spend a much longer amount of time with patients. NPs dont rush in and out of rooms in 5 minutes like the MDs do.

NPs that see as many patients as MDs will make a similar amount of money.

Most of the practices I've seen that have both NPs and MDs, the MDs see about double the number of patients per day that the NPs see.

Another reason for the difference in income is that MDs make a lot of money by "supervising/collaborating" with PAs and NPs; whereas NPs and PAs cant get paid for "supervising" anybody.

westcoastgirl · May 30, 2010

I've asked the same question myself. And around here, we see the same patient loads as the MDs so no they're not seeing "double the number of patients". A professor told me it's because we sell ourselves short as a profession which is sad but I think true, it's like there's a culture of we can't talk about money and be a good NP at the same time.

wwatts1 · May 30, 2010

So do you work on a salary? It seems like NPs who ran their own clinics would make 130k, and maybe they do... but it seems like everywhere I look they estimate the ones who work for themselves make only like 79k! Less than NPs who work for others! I am sure do to the cost of running a clinic.

core0 · May 31, 2010

If NPs are being reimbursed 85% of what doctors are for the same care, why do NPs make so much less?? If an average family MD makes $160,000 an average FNP would make $136,000. But... they make $85,000. How does that happen?

First of all the 85% rule only applies to Medicare. Other insurance will pay negotiated rates which may be more or less than Medicare. The reason that the salary difference are myriad but probably revolve around the number of FPs that own their practices relative to NPs. NPs that own their own practice have the highest salary for NPs:

http://nurse-practitioners.advanceweb.com/SharedResources/Downloads/2009/122809/NP010110_p24table3.pdf

However, for a variety of practice reasons FPs are going to make more than FNPs in almost any setting.

David Carpenter, PA-C

dgenthusiast · May 31, 2010

Because NPs are less "efficient" than MDs. MDs routinely see 50-60 patients in clinic per day, whereas NPs provide "holistic, patient based care" and therefore spend a much longer amount of time with patients. NPs dont rush in and out of rooms in 5 minutes like the MDs do.

I really hope you don't actually believe this nonsense. The idea that MDs/DOs don't provide "holistic" care is ridiculous. It may have been true in the 70s but it's definitely not true in this day and age. Medical training places a focus on the "whole patient," not the disease (whatever that means) like some people on these forums would have you believe. Nurses are not the jedi masters of holistic care. Whether a provider chooses to provide holistic care or not depends on that individual, not the training through which they've gone through.

You are right, however, that NPs tend to see, on average, a lower volume of patients than physicians.

wwatts1 · May 31, 2010

Thank you David that link was very helpful! I was going off of numbers from AANP, NP central, and the labor bureau statistics on PAs none of which were as specific as your link! I never expected to make an FP's salary, I was just surprised to know how large the divide was, and wondered about the medicare percentage, but it makes sense about the private insurance. Thanks!