share experience as a PMHNP

[KMuniz, APRN]

Hi!

I was curious to hear from other PMHNP who want to share their experiences as PMHNP. I have been working for about 6 months in private practice in Houston area, but I feel like "It's a promised land"...no good pay, get 52% of what they bill they say, want you to see patients every 20 min (and check T, BP, open your note, schedule the next visit for the ones seen, DON'T make the pt wait) which in my opinion, is very stressful, and besides you always have to reply to patient's messages through Klara or emails, write referral letters or different letters that the patients ask you to. It looks like I put more hours (after work hours) that I thought only to reply or finish charting. Patients always ask you to refill meds between the visits, etc. As a part-time PMHNP I make about $2,500 seeing around 50-55 patients in a month; I see kids too, which is like ouble work as I talk to the child then I start all over w/the parent... NPs in the office see 15-20 patients/day, and I cannot imagine this workload, and I am not sure how much they make, but to me it's like they all take work home. I appreciate you sharing your experience!

[umbdude, MSN, APRN]

Is the $2,500/month after tax withholding? If you're seeing 55 patients a month and you see 3 patients an hour, you're working ~18 hours a month. That's $139 per hour, which isn't horrible if it's after the split and tax. Are you utilizing add-on codes if you're billing simple 99213 or 99214?

Regardless, one of the biggest draw to private practice is autonomy. If you're being told how to practice (e.g. 20-min appts and have to respond to patients within 24 hours) and have to do your own vitals, it's not worth paying that 48% to the company. (That said, booking your own follow up appts is standard practice and actually better.)

I have experience with another large fee-for-service telepsych company and will be starting at a small private practice soon. Feel free to PM me if you want to discuss.

[Gentleman_nurse, MSN]

OP, This place sounds like LifeStance Health. They've been buying up practices nationwide and take 48% of your fees billed. I've been seeing many telepsychiatry startups recruiting providers by selling the 'it's your own private practice' idea. It's the worst of both worlds. You take on the business risks of an entrepreneur but have the autonomy of an employee.

[verene, MSN]

That sounds horrible. I work inpatient, .8FTE W-2 employee with good benefits.  Base salary works out to a little over $80/hr, and  the combo of differentials and overtime pay means take home actual pay is usually above base salary. Typical panel size is 12-14, but may be larger temporarily if providing cross-coverage.  This may sound small but it's a high acuity/high complexity population, and the workload adds up very quickly, so I do stay late/come in early to work on documentation or care coordination or other tasks at times.