What is the average hourly pay for a FNP

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I live in NJ and work as an RN in a specialtyunit. I'm considering going for the FNP program this fall. I would like to know what is the average pay i could make as a FNP. Also how easy would it be to get a job as a FNP? Would i be able to work in acute care or would i end up in a family clinic?

Keep in mind when talking about bill rates and what an NP bills - that that doesn't necessarily translate into what is collected/reimbursed.

An NP (or MD) may bill out 60k in one month - but what is actually reimbursed/paid by insurance and patient copays might only amount to about 20k or 40k or... You need to know that too. And then you also need to know what percentage of the income in the practice is being applied to overhead.

60k billed out sounds like a lot - and it is - but if actual reimbursed/collected rate is only 60% of that, and overhead is 80% of what is collected, that leaves 7200.00

Of course reimbursement and collected rates will differ in different types of practices and practice settings, different areas of the country, and different patient populations. Overhead expenses will also vary pretty widely.

It is best to find out data that is applicable to the type of practice you are in, that way you can base negotiations on solid info. Just knowing what you bill out in a month may not be enough.

That is true, but there is no way that over head is even close to 80% of what is collected. Clinics can collect generally anywhere between 60-80% of what is billed. The Doc I'm with seldom shows up (like never), I make 100,000+ , and he lives in a very large house on the hill. His wife just got implants, and he just got back from taking his whole family to Japan. He also drives a $90,000 Mercedez as well as an Escalade. That was nice of me to pay for all that. Being an efficient coder also makes a big difference in collections.

I am now considering opening a cash only clinic. The numbers look pretty good for that.

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Specializes in ICU, ER, HH, NICU, now FNP.
That is true, but there is no way that over head is even close to 80% of what is collected. Clinics can collect generally anywhere between 60-80% of what is billed. The Doc I'm with seldom shows up (like never), I make 100,000+ , and he lives in a very large house on the hill. His wife just got implants, and he just got back from taking his whole family to Japan. He also drives a $90,000 Mercedez as well as an Escalade. That was nice of me to pay for all that. Being an efficient coder also makes a big difference in collections.

I am now considering opening a cash only clinic. The numbers look pretty good for that.

Like I said - it can vary widely - I don't doubt that your case is the case is some places. It just isn't the case everywhere.

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Specializes in ER, critical care.

over 100K here in TN for base salary.....

total compensation package around 150K

There is another perspective.

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That is true, but there is no way that over head is even close to 80% of what is collected. Clinics can collect generally anywhere between 60-80% of what is billed. The Doc I'm with seldom shows up (like never), I make 100,000+ , and he lives in a very large house on the hill. His wife just got implants, and he just got back from taking his whole family to Japan. He also drives a $90,000 Mercedez as well as an Escalade. That was nice of me to pay for all that. Being an efficient coder also makes a big difference in collections.

I am now considering opening a cash only clinic. The numbers look pretty good for that.

Finally, someone that thinks like I do. Okay, that's two of us. Now if we can just get to the other hundred thousand so they'll quit working for peanuts and giving every employer a reason to offer $55K/yr to NPs.

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I'm around the $100K salary mark. In the process of negotiating productivity clause. I'm in the midwest, in primary care (6 hrs/day) with 1:4 call for a small rural ED/hospital. With benefits and loan repayment program, I'm around the $150K/yr mark.

Before this, I was in a cash clinic on pace to make almost $200K. Didn't like it, so I chose the temporary pay cut. The way I see it, if you want to make a lot of money, you can find a way how no matter what specialty. Look at MSN BC FNP's practice. Peds is supposed to be the lowest paid specialty, yet he's making money in the top 1% of NPs.

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I'm around the $100K salary mark. In the process of negotiating productivity clause. I'm in the midwest, in primary care (6 hrs/day) with 1:4 call for a small rural ED/hospital. With benefits and loan repayment program, I'm around the $150K/yr mark.

Before this, I was in a cash clinic on pace to make almost $200K. Didn't like it, so I chose the temporary pay cut. The way I see it, if you want to make a lot of money, you can find a way how no matter what specialty. Look at MSN BC FNP's practice. Peds is supposed to be the lowest paid specialty, yet he's making money in the top 1% of NPs.

Not that it matters, but I'm a she. Why didn't you like the cash clinic?

Finally, someone that thinks like I do. Okay, that's two of us. Now if we can just get to the other hundred thousand so they'll quit working for peanuts and giving every employer a reason to offer $55K/yr to NPs.

I'm convinced if the NP profession were dominated by men, starting salaries would be much, much higher. Most of us women just bend over and take it the way were told to take it. I know an NP (woman) that managed to negotiate a 35,000 dollar a year salary for running a University health clinic. It's NPs like her that set all of us back. It really made me kind of mad. No one should of taken that job until they paid much more.

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Not that it matters, but I'm a she. Why didn't you like the cash clinic?

I'm convinced if the NP profession were dominated by men, starting salaries would be much, much higher. Most of us women just bend over and take it the way were told to take it. I know an NP (woman) that managed to negotiate a 35,000 dollar a year salary for running a University health clinic. It's NPs like her that set all of us back. It really made me kind of mad. No one should of taken that job until they paid much more.

Sorry... made the "he" assumption based your comment about the profession and women.

The cash clinic was okay, but many different reasons for leaving... boring work, horrific scheduling (70 patients to see me one day, then 4 the next), no benefits, long hours, among others.

I will, however, consider doing my own cash clinic similar to the one I used to work at if I can find a doc to sign off and leave me alone. I was on pace to make nearly $200K/yr, but the doc that owned the place was on pace to make around half a million from my work alone.

What you say is true regarding gender, whether we like it or it's politically correct or not. I too know of NPs that take meager wages simply because it's what was offered. I got offered $55K/yr and I asked them what they wanted me to do the other six months out of the year. I hope they got the message. Those who accept those kind of offers make hospital administration feel like they can pay NPs whatever they want, and they all talk amongst themselves about what they're paying "midlevels". I've found that most decent administrators will entertain the idea of productivity because it's good business. We make more, they make more. I think it's rediculous to do anything else. Salaries, no matter what the level, breed laziness. Why should I schedule a procedure at the hospital before my clinic schedule and have to get up earlier and work harder if I could just refer it out and sleep another hour? Why should I see more than 10 patients a day and bust my butt if I get the same no matter what? It just breeds laziness and poor customer service.

I couldn't agree more that NPs/PAs need to focus on making it the norm to expect closer to GP physician salaries. From a business standpoint, it doesn't make sense to expect lower salaries. Our services are billed at least 85% of the physician (most are equal). So why are we accepting 30-40% of their salaries? Because they are "doctors"? That doesn't show up on the balance sheet. Yes, they are better trained, and can handle sicker patients. And, they take time (albeit very little in most cases) to collaborate with us. These are the reasons I don't think the salaries should be equal. But I sure as hell don't think they should be so far apart. But, I fear the vast majority of NPs don't even come close to thinking of this and could care less anyway. After all, most have been RNs for many years and are conditioned to the medical society's self-created heirarchy that puts them on an untouchable pedistal.

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Specializes in Critical Care, Emergency, Primary Care.

I'm feeling really inadequate now. I work in a clinic system that feels that I am "WELL COMPENSATED" for my work. They just included an "Incentive" program in my latest contract that doesn't kick in until I am basically 1100 patients above my current average. I'm making an average salary that falls into about the 26th percentile of the national average. When I pointed it out, they actually had the audacity to pull out a 2004 salary survey and show me that I was making exactly what everyone else is. (3 years ago).

Maybe I need to uproot my family and find a place that actually finds worth in what I do?

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Here's some more good info on productivity bonuses.

complete article at link

http://www.medscape.com/viewarticle/413405

In another, simpler, productivity arrangement, the NP agrees to bill twice his or her salary, and agrees that the NP will receive some percentage of all billings over that number. For example, NP and employer agree to a salary for the NP of $70,000, agree that the NP will bill $140,000, and agree that the NP will receive 20% of billings in excess of $140,000. The numbers can be adjusted, depending upon the practice's collection rate. For example, if the collections rate is 90%, the NP making $70,000 might agree to bill $155,555.

Capitated Reimbursement

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I'm feeling really inadequate now. I work in a clinic system that feels that I am "WELL COMPENSATED" for my work. They just included an "Incentive" program in my latest contract that doesn't kick in until I am basically 1100 patients above my current average. I'm making an average salary that falls into about the 26th percentile of the national average. When I pointed it out, they actually had the audacity to pull out a 2004 salary survey and show me that I was making exactly what everyone else is. (3 years ago).

Maybe I need to uproot my family and find a place that actually finds worth in what I do?

I would seriously consider looking around. The worst that can happen is you don't find anything, but I doubt it. Just make it clear that you don't want any prospective employers to contact your current employer until you say it's okay (ie after you've negotiated then spoke with your current employer yourself).

I suspect you'll be offered a better deal, and can take this back to your employer and just tell them either match it or you'll be forced to turn in your resignation.

To show you figures from 2004 is idiotic. Whoever did that is a moron. They all feel like the NPs are "well compensated". But what are they basing this opinion on? Compared to pizza delivery? It makes no sense.

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Specializes in Critical Care, Emergency, Primary Care.

The Morons were actually the Executive Director and the Attorney who is president of the board of directors. I'm an anomaly for them. There are two Mid-level providers that have worked in the system for years, but, they keep their mouths shut and take what they are given with great gratitude. This area is tight for NP's... even in the University system, the salary ranges for an NP are $25.34 - $42.67 Average is $34/hour. Most of the positions want to pay wages that are far below acceptable, and a good number of physicians still view NP's as no better than a Nursing ASSISTANT.

[EVIL][/EVIL]

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The Morons were actually the Executive Director and the Attorney who is president of the board of directors. I'm an anomaly for them. There are two Mid-level providers that have worked in the system for years, but, they keep their mouths shut and take what they are given with great gratitude. This area is tight for NP's... even in the University system, the salary ranges for an NP are $25.34 - $42.67 Average is $34/hour. Most of the positions want to pay wages that are far below acceptable, and a good number of physicians still view NP's as no better than a Nursing ASSISTANT.

I am a BSN, RN making 41.00/hour first 8 hours and 68.00 last 4 hours of 12 hour shift. The NP wages that are disucssed seem so low! I contemplate going to grad school, just not sure the additional education would be worth it.

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