PICC Placement Differences State to State

[RN VA-BC]

Hello, I am looking to see what other RNs make for outpatient vascular access services. Or, has anyone started their own PICC company and have any words of advice?

I am currently a vascular access nurse at a 550 bed hospital in California. We place PICCs, Midlines, PIVs with U/S, CVC dressing changes etc. I love my job, but my husband and I have decided to move back to NJ.

I am having a very difficult time finding hospitals in NJ with PICC teams - this seems to be a service mostly done in IR in NJ. This has me looking in to outpatient PICC companies. I know the medicare reimbursement rate for a PICC placed inpatient is very low, but the reimbursement rate outpatient seems quite high.

There is an outpatient company near me in CA that offers almost $300 for an outpatient PICC placement. However, an outpatient PICC company I just spoke to in NJ only offers $175 per PICC. Is the company in NJ really making less off of the PICC I place and, therefore, paying me less. Or, are they making the same off of the PICC as compared to CA and paying me less? Does the medicare reimbursement rate vary state to state? Or is this totally dependent upon the rate the outpatient PICC company negotiates with their contracts at SNFs and other outpatient facilities?

I would be a private contractor for this company in NJ requiring malpractice/liability insurance. Just seems like I would be taking on 100% of the risk, doing most of the work involved with the PICC placement, and perhaps only getting a very small percentage of the revenue generated from the PICC placed. I think being a vascular access nurse is an unique specialty and I want to be compensated appropriately for what I do and the services I am able to provide.

Any advice would be greatly appreciated.

Thank you!