dhageremtp Posted January 8, 2011 Share Posted January 8, 2011 Question for any of you with experience in RVU based bonus, I have the option of taking a flat lump sum dollar bonus at the end of my contract year or take a bonus based on a multiplier times the number of RVU units I have in a year. Can anyone give me an idea what their RVUs add up to in a year? I work in a family practice office average is about 15 patients per day. Just looking for friendly advice as to which option seems better. Thanks! Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 8, 2011 Moderator Share Posted January 8, 2011 in the ER we would get bonused for anything over 6RVU/hr I think FP is WAY below this I see 25 pts/day and get squat.... Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 13, 2011 Moderator Share Posted January 13, 2011 a little leg work and this is what I come up with. If you see 22 patients a day at the following breakdown 1 new patient at a 99205 2 established patients at a 99215 8 established patients at 99214 6 established patients at 99213 5 established patients at 99212 RVU CODE 0.63 99201 1.72 99202 1.91 99203 3.62 99204 4.58 99205 0.57 99211 1.02 99212 1.39 99213 2.18 99214 3.17 99215 Calculations Daily RVU is 41.8 With a four day work week and 44 weeks a year of employment that is 7356.8 RVU’s billed in a year. Then it gets confusing as you could have an endless way to handle bonus, montly/quarterly/yearly(avoid yearly) I would back into it with what your desired salary is (ie 100k) Base 60,000/year Anything over 500 RVU’s in a month get $x/rvu Anything over 600 RVU’s in a month gets $x/rvu Link to comment Share on other sites More sharing options...
coloradopa Posted January 13, 2011 Share Posted January 13, 2011 a little leg work and this is what I come up with. If you see 22 patients a day at the following breakdown 1 new patient at a 99205 2 established patients at a 99215 8 established patients at 99214 6 established patients at 99213 5 established patients at 99212 RVU CODE 0.63 99201 1.72 99202 1.91 99203 3.62 99204 4.58 99205 0.57 99211 1.02 99212 1.39 99213 2.18 99214 3.17 99215 Calculations Daily RVU is 41.8 With a four day work week and 44 weeks a year of employment that is 7356.8 RVU’s billed in a year. Then it gets confusing as you could have an endless way to handle bonus, montly/quarterly/yearly(avoid yearly) I would back into it with what your desired salary is (ie 100k) Base 60,000/year Anything over 500 RVU’s in a month get $x/rvu Anything over 600 RVU’s in a month gets $x/rvu Thats pretty aggressive. The MGMA data says the average FP sees around 4700 RVUs per year. Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 14, 2011 Moderator Share Posted January 14, 2011 Thats pretty aggressive. The MGMA data says the average FP sees around 4700 RVUs per year. i believe it as i know PA's and NP's seeing 10-15 patients per day. this is what I think I can handle in an office with good support - right now I am seeing 25 per day and about 80% get billed at a 99214 this is about 50 RVU's per day - I am on the quicker side of things and my days are over 7 hours of clinic time (little paperwork time) Use templates and dragon voice to print figure in my current job I am generating 50 RVU/day 4 days/week 200 RVU/week for 44 weeks per year is over 8000 RVU's per year - that is about 350,000 in receipts...... points out one of the things I think PA's need to improve on - the business of medicine and productivity - I actually left one job (I was bored) as I was only expected to see 12 patients a day - yawn..... There is a GREAT opportuinity to own a practice in internal medicine - doc's grumble as they can not make 200k/year with a 4 day work week and the same people they went through med school with that are now surgeons or rads are making 400+ per year. BUT a PA owning a pracitce (by my math if you take home 30% of receipts - Docs figuring on taking home about 40%) you can be in the 120k/yr this is crap pay for a Doc - but great pay for me! :-) for primary care PA's out there - how many patients do you see and what is your most billed code? Link to comment Share on other sites More sharing options...
coloradopa Posted January 15, 2011 Share Posted January 15, 2011 i believe it as i know PA's and NP's seeing 10-15 patients per day. this is what I think I can handle in an office with good support - right now I am seeing 25 per day and about 80% get billed at a 99214 this is about 50 RVU's per day - I am on the quicker side of things and my days are over 7 hours of clinic time (little paperwork time) Use templates and dragon voice to print figure in my current job I am generating 50 RVU/day 4 days/week 200 RVU/week for 44 weeks per year is over 8000 RVU's per year - that is about 350,000 in receipts...... points out one of the things I think PA's need to improve on - the business of medicine and productivity - I actually left one job (I was bored) as I was only expected to see 12 patients a day - yawn..... There is a GREAT opportuinity to own a practice in internal medicine - doc's grumble as they can not make 200k/year with a 4 day work week and the same people they went through med school with that are now surgeons or rads are making 400+ per year. BUT a PA owning a pracitce (by my math if you take home 30% of receipts - Docs figuring on taking home about 40%) you can be in the 120k/yr this is crap pay for a Doc - but great pay for me! :-) for primary care PA's out there - how many patients do you see and what is your most billed code? In theory a 99214 should take around 25 minutes according to Medicare. If you are seeing 20 patients per day at 99214 (80% of 25 patients) then you should spend 8.3 hours on that alone. You could argue that you are just more efficient but thats supposed to be the average (some shorter and some longer). Also the percentage of 99214s you are seeing is reversed from the national average (20%) http://www.aafp.org/fpm/2004/0600/p20.html. This is the kind of practice variance that shows up on Medicare audits. You could argue that your practice is significantly different from the average but it would be on the order of three SD from the mean. Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 15, 2011 Moderator Share Posted January 15, 2011 In theory a 99214 should take around 25 minutes according to Medicare. If you are seeing 20 patients per day at 99214 (80% of 25 patients) then you should spend 8.3 hours on that alone. You could argue that you are just more efficient but thats supposed to be the average (some shorter and some longer). Also the percentage of 99214s you are seeing is reversed from the national average (20%) http://www.aafp.org/fpm/2004/0600/p20.html. This is the kind of practice variance that shows up on Medicare audits. You could argue that your practice is significantly different from the average but it would be on the order of three SD from the mean. only partly true - you have the time correct but that is only one part of the equation. The other part is decision making. if you only code per the time spent and not the guidelines you are likely undercoding. check out http://www.aafp.org/fpm/2005/0900/p52.html for more details but pretty much if you take a good History, get a social history, have an urgent care visit for a new problem, review previous problems (ie htn on atenolol) and take vitals you are at a level 4 visit. A cold in someone like this might appear to be a simple issue but when you put together that you have reviewed the med list, assessed the BP, assesses a new medical problem, reviewed that fact rather they got a flu shot this year you are solidly in the 99214 area------ but many doc's forget all they do, don't capture it in the note, or are afraid of audit and down code...... History: CC History: HPI History: ROS History: PFSH Exam Medical decision making 99213 Required 1–3 elements Pertinent Not required 6–11 elements Low complexity 99214 Required 4+ elements 2–9 systems 1 element 12 or more elements Moderate complexity (or 3+ chronic diseases) I did an audit on my charts and I was coding most visits as a 99213 but in review most were 99214...... one chronic stable problem and one new problem is a level 4 Link to comment Share on other sites More sharing options...
riccorman Posted February 5, 2017 Share Posted February 5, 2017 I am an employed primary care physician who was recently transitioned from a salaried position to a productivity-based employment contract. Prior to this, I never really paid much attention to my productivity, other than listening to administrators telling me to "see more patients." Once my compensation became tied to these numbers, however, I became intensely interested in how my productivity is determined. I developed an iOS app to allow me to calculate my work RVUs at the time of coding, while I'm seeing patients. Using the app in my practice has dramatically increased my productivity by making me aware of how the CPT codes I apply affect my reimbursement. As an added bonus, I can now keep track of my OWN productivity, and I don't have to rely blindly on a health care administrator to provide me that data. I have further developed this app, RVUcalc, for the use of other clinicians and made it available for download in the iTunes App Store for $3.99. If there is enough interest, I will also port the application to the Android platform. It is a very simple app, but it is lightning fast and very easy to use. I have found many different uses for it in my practice. But I think its biggest value lies in what it has taught me about the relative values of the CPT codes I use every day, and how I can optimize those codes for maximum compensation. I feel that it would be very beneficial to EVERY provider on a production-based compensation model, or any provider who wants to gain insight into their productivity numbers. It is available in the iTunes app store and more information, including a preview video, can be found at my website: http://rvucalc.com I sincerely hope that someone here might find this useful in getting a handle on their productivity. Thanks Link to comment Share on other sites More sharing options...
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