PICC bu$ine$$ info dump

Specialties Infusion

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okay, for a couple of months now i have heard of various success rates with picc-certified nurses who have broken off with their hospital and independently formed a group that goes to hospitals in their area to insert PICCs.

1. how many of you are doing this and what is the success rate like? one picc a day demand? more than one a day?

2. what is the demand with the hospitals? i know that our hospital trains the supervisors to insert piccs so they "save" on FTE.

3. what is the pay rate like? i heard that its something like 300$ per insertion here in los angeles.

i hope to go into this because it seems like a huge revenue stream that not many are going into (partly because its expensive to train--500$ theory package for MST/US plus additional clinical/actual insertion training--and that not many want to train others).

there is another way that i heard to do this--and that is to partner with an MD who almost always needs a picc for his patients (oncology/chemotherapy, neurosurgeon/neurointerventionalist, intensivist/ICU) and then insert piccs for his demand. the pay i hear is lower--200$ per insertion but then you get the advantage of referral and guaranteed business by way of the MD (of course the MD gets a cut).

4. how many of you are doing this route?

5. what is the success rate like? how is the experience and can you partner with multiple MDs (for more business)?

i also know that medicare reimburses 600$ for picc placement and an additional 80$ if it is with ultrasound--so this is a good business to go into.

i am really studying how to get into this business as i feel i am more a "technical"/"skill"-nurse than a bedside nurse. i have 6 months experience in the SICU fresh from school and i could say i am pretty competent compared to others.

lastly,

6. where do you get the picc materials (actual picc) to train with? i can buy the dvd and books online, but none offer the actual insertion kit.

7. who certifies us as a picc-certified nurse? various companies online are offering classes, but is there an actual, formal, CERTIFICATION given by a goverened body like BRN? companies often just quote position papers by INS/AVA. is this legal?

8. what is the longest time it would take for a picc insertion? i have watched a few and they always never go beyond an hour. 300$ for one hour's work looks sweet, imagine five of them in a day--that's my two weeks' pay!

let me know your thoughts and thanks to those who take the time to read and answer, your help is immensely appreciated and valued.

p.s.--yes, i know there are a bunch of RNs out there who will hurl the traditional "you need years of experience first!", "you're fresh out of school and youre doing this already, take one step at a time", "you should never have gone into nursing if $$$ is all you think of", "stop having delusions of grandeur and earn your time the way we did".

please. do us all a favor and just answer the questions and help out. i highly respect those that paid their dues and got to where they are through difficult means. please find merit in just answering factually the questions aired.

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Demand will be based upon your area, best bet is to get training then offer services to area clinics, hospitals, SNFs it will require marketing.

Keep in mind, if the x-ray showed improper length ect you will have to go back and modify placement this migh tbe at no additional reinbursement for you and consume your time. How long will it take to get the x-ray and have it read.

The picc line kits I use are over 100 each. If you have to provide your own supplies that can quickly reduce your profit if you need to open an extra pack.

There is not formal certification for PICC nurses, yu can have a certificate of completion for a course. In all states that I have looked at RNs can place PICCs.

Simple piccs are fast, I do all of mine with ultrasound and x-ray. Hard ones, veins going into spasm ect can be time consuming. Longest I have seen was 2 hours.

Contact the PICC companies to see what is required for you to order them ie BArd, Cook, angiodynamics. You will probably need a MD/NP/PA to order them but I am not sure.

Jeremy

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Demand will be based upon your area, best bet is to get training then offer services to area clinics, hospitals, SNFs it will require marketing.

Keep in mind, if the x-ray showed improper length ect you will have to go back and modify placement this migh tbe at no additional reinbursement for you and consume your time. How long will it take to get the x-ray and have it read.

The picc line kits I use are over 100 each. If you have to provide your own supplies that can quickly reduce your profit if you need to open an extra pack.

There is not formal certification for PICC nurses, yu can have a certificate of completion for a course. In all states that I have looked at RNs can place PICCs.

Simple piccs are fast, I do all of mine with ultrasound and x-ray. Hard ones, veins going into spasm ect can be time consuming. Longest I have seen was 2 hours.

Contact the PICC companies to see what is required for you to order them ie BArd, Cook, angiodynamics. You will probably need a MD/NP/PA to order them but I am not sure.

Jeremy

thanks for the reply, some follow-up questions...

where do you get your picc kits? can i buy them too or can i just buy them from you?

what is the bard/cook/angiodynamics? i have seen many types of piccs--what are the differences of each (like powerpicc)?

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different companies make kits for piccs, bard, cook and angiodynamics are three examples of companies you can contact a local rep to see about purchasing piccs.

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:nono: It takes more than technical skills to place PICC lines. There is a great amount of time spent with the patient during the PICC placement. In order to place lines you need to be educated on multiple aspects of PICCs, not just the technique of placing them. Placing PICCs is not a "get rich quick" scheme.:banghead:
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Specializes in Infusion Nursing, Home Health Infusion.

Inee, I have been placing PICCs since 1989 and was on the first team based approach to placing PICCs in northern California. If you are truly interested in this the first step is to take a beginners PICC class then try to get on a hospital based PICC team to get some really good training. If you get on a good progressive team you will be able to build your skills and knowledge base. Infusion nursing and PICC and CVC placement is a speciality and requires more than you would think at this point.

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Hello INEE,

Have you gotten any more information about starting a picc line insertion service?

Thanks,

bill00466

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I too an looking extensively into starting my own PICC consulting company. In order to order medical equipment it is necessart to start accounts with vendors (i.e. cardinal, bard, etc). They will look at your credit, negotiate a contract (i.e. you promise to give x amount of dollars to Bard in one year's time) and then quote you prices. So it is accounts through each vendor that are necessary for you to acually purchase medical equipment.

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I have been contacted to place piccs at a couple of smaller facilities. I am curious as to how much you bill the facility to place the line. If those of you out there would feel comfortable giving me a ball park figure i would appreciate it. I dont want to charge to much or to little. You can PM me if you dont want it posted.

Thanks

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Bob, I am also trying to find out what other companies are charging but am having a hard time. I will email back soon with pricing that I have found so far in my extensive searches.

Liz Holowasko BSN, RN, CRNI

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Although I did not run my own compoany I was an independent contractor for over 15 years and worked closely with my bosses who started up the PICC companies. It is not as easy as you think.. First of all, you have to have your supplies ahead of time. Before you earn your first paycheck, you will owe the supply companies hundreds if not thousands of dollars. You need to be licensed and permitted by your local governing agencies and you neeed to have which depending on your state can be very costly. Second, forget about having a life. You will be on call all day every day. It would be nice of you could put in 5 PICCs from 9am to 3pm and be done, but it don't work that way. Typically whoever wants a PICC wants it NOW, but you can only be in one place at a time. If you can't provide immediate service, they will call someone else, or send the patient somewhere else. There is the wear and tear on your car as you spend your lilfe driving from one place to another all day long. A lot of people who start their own companies will hire a sub (such as I was) so that they can increase coverage and pick up more business. The business owner has to be willing to work with negative cash flow until they start turning a profit, but the subs need to b e paid regularly like normal people. my old boss was repaying loans she took out to start the PICC business for YEARS, probably still paying them. Also reimbusement can take months and usu does. Insurances have to be billed, and you will have to wait in line with everyone else for the reimbusement. Also you have a lot of competition out there with the bigger companies that are trying to provide this service i,e, pharmacies. The trouble with all these companies, (and almost anything medially related) is new companies come and go like the weather, old companies merge, get bought out, reinvent themselves, whatever. You may sign with one company, then they lose a big contract, and you have no work. I is actually easier to be an indepenent contractor than to start your own business. But let me reiterate, the moeny is great ONLY if you are willing to be on call ALL THE TIME. If they call you and you won't do it , they will call someone else. Ultimately they will call the one that says YES the most often. I had days where I placed no lines or one line. You never know what your schedule is one moment to the next. I did it. I loved it. I got completely burned out. But do not think for one moment it is easy money.

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I too am starting a PICC line business and my area and would love to trade information and research. I'm very serious about this and would love any feed back from other nurse entrpremeurs out there doing the same.

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