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How are PA's paid?


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I'm a pre-PA student, and I'm having the hardest time finding answers to how a PA salary is structured. I'm asking the question here since you are all seasoned PAs.

 

Are PA's paid a flat salary, such as $90k a year, working 40 hours a week, paid by the hospital (assuming you're employed in one), no matter what the caseload is? If that is the case, why are we concerned with reimbursement rates? Or do you get paid on a commission basis for the amount of patients you see or the surgery you perform? Any light you can shed on this would be greatly appreciated.

 

I only know of hourly wage structures paid to nurses and have no idea how PAs/physician salaries work. Thank you.

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Salary structures are as varied as heir are practices.

 

If you are an employee, you might be straight salary.. 90k for an assumed 2000 work hour year (40 hrs/ x 50 weeks) plus bennies... Depending on employer size, OT can get sticky.. I no of few PA s working 40/wk, and fewer yet actually getting OT, though recent case law has excluded PAs as highly paid employees exempt from OT rules, so this should be noted in your contract.. If paid, what rate, etc...

You will ge paid biweekly, or monthly.

 

You also could be a non salaried employee.. Paid an hourly rate, say $45/hr (90k equiv). With bennies paid for either by employees straight out, our subtracted from your hourly rate using pretax dollars..again, contract issue.

 

Or you could be an employee being paid a salary (straight or hourly), plus a productivity fee ( if you generate x dollars above a preset minimum, or see x number pts/hour above a certain minimum, then your hourly rate will increase or you will get a bonus paid at some interval (mo they, qrtrly)), with te bonus tiered so that the higher your production, the greater the bonus.

 

Or you could be an I dependent contrActor, who us paid at a predetermined monthly, quarterly, or weekly rate ( I will work for you for 90 days for, say $35k), or hourly. Biggest difference between independent contractor and employee is tax status. As an independent contractor, you will VE a 1099 employee", meaning that you will VE responsible for paying all of your taxes, and Ira/ Sep Ira, out of your salary.. The employer pays nothing on your behalf. If you go this way, you should roughly add 15-23% to your basic hourly rate to compensate for the additional costs you will incur ( an additional 7.83 per engage to your FICA hit, you pay your own retirement, your own med-dent, life insurance.. Benefit is huge increase in putting pretax dollars into retirement accounts. IRS is beginning to really frown on IC PAs however.

 

The standard is that most everyone gets paid 2-4 weeks after the current month.. Either bimonthly or monthly. With taxes and fees withheld for you by employers if you are a salaried (straight or hourly) employee, or nothing withheld and all your responsibility for paying taxes if you are an Independent employee.

 

Does this make sense?

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Salary structures are as varied as heir are practices.

 

If you are an employee, you might be straight salary.. 90k for an assumed 2000 work hour year (40 hrs/ x 50 weeks) plus bennies... Depending on employer size, OT can get sticky.. I no of few PA s working 40/wk, and fewer yet actually getting OT, though recent case law has excluded PAs as highly paid employees exempt from OT rules, so this should be noted in your contract.. If paid, what rate, etc...

You will ge paid biweekly, or monthly.

 

You also could be a non salaried employee.. Paid an hourly rate, say $45/hr (90k equiv). With bennies paid for either by employees straight out, our subtracted from your hourly rate using pretax dollars..again, contract issue.

 

Or you could be an employee being paid a salary (straight or hourly), plus a productivity fee ( if you generate x dollars above a preset minimum, or see x number pts/hour above a certain minimum, then your hourly rate will increase or you will get a bonus paid at some interval (mo they, qrtrly)), with te bonus tiered so that the higher your production, the greater the bonus.

 

Or you could be an I dependent contrActor, who us paid at a predetermined monthly, quarterly, or weekly rate ( I will work for you for 90 days for, say $35k), or hourly. Biggest difference between independent contractor and employee is tax status. As an independent contractor, you will VE a 1099 employee", meaning that you will VE responsible for paying all of your taxes, and Ira/ Sep Ira, out of your salary.. The employer pays nothing on your behalf. If you go this way, you should roughly add 15-23% to your basic hourly rate to compensate for the additional costs you will incur ( an additional 7.83 per engage to your FICA hit, you pay your own retirement, your own med-dent, life insurance.. Benefit is huge increase in putting pretax dollars into retirement accounts. IRS is beginning to really frown on IC PAs however.

 

The standard is that most everyone gets paid 2-4 weeks after the current month.. Either bimonthly or monthly. With taxes and fees withheld for you by employers if you are a salaried (straight or hourly) employee, or nothing withheld and all your responsibility for paying taxes if you are an Independent employee.

 

Does this make sense?

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Some caveats about being an independent contractor. In most situations, PAs can not be considered independent contractors under the rules of the IRS. I studied this issue carefully, with labor attorneys, when I set up my staffing company and concluded that it was not allowable.

 

The risk is all on the employer side. However, unless the employer is paying you a boat load of money, it is most of the time only beneficial to the employer as he or she avoids all the payroll taxes and benefits. If the arrangement is investigated by the department of labor, the employer can count on back taxes, penalties, overtime, etc. to make the employee whole in the eyes of the law. The risk on the employee side is that you are screwed out of money, taxes contributions, SSI, state disability, etc. Don't count on the employer looking out for your interests. They are doing it to save money; not pay you more money.

 

They way that I side step this question now is that I work for my corporation and pay myself a salary. All the physicians with whom I work contract with my corporation for services. I'm considered a "leased employee" to the physicians. This is the only way that I know that PAs, at least in California, can be considered independent contractors.

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  • 4 weeks later...
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not sure if this is true - but just putting it out there

 

in the past mostly (in my area) just a salary - usually for a certain # of clinic hours - then if you need more time to finish charts or paperwork that is not paid - ie 90k/year for 4 days of clinic

 

no productivity or mention of prodoctivity bonus

 

 

I 'think' maybe this is changing a little bit to having an awareness of what we generate (or maybe it is all in my own mind) and wanting to have a part of the profits.....

 

So base salary (for non-ER or shift work jobs) ir primary care - and hopefully a bonus tied to productivity.

 

 

ER and Urgent Care - almost always hourly (with or without PTO)

 

Hospital work - ie hospitalist - salary

 

contract work - I just took a job for a (gulp)insurance company doing History's in complex patients homes - flat rate per visist as an employee with out bennies - but the rate is nice

 

Locums - get hired by a locums company and get a flat hourly rate

 

 

 

One thing that just gets my goat - ER's or urgent care the do NOT pay overtime - if we go over 40 hours we should be entitled to atleast straight time and honestly I would be very hesitant to ever take a job that did not have time and one half over 40 hours - I don't want to work more then 40 hours, and getting forced to do it for straight time is huge savings for the employer (no fixed overhead of hiring additional employees) so they are just profiting on your labors (when I would rather be at home)

 

 

I would second the avoidance of 1099 status - just doesn't work for most and puts the employer at risk and basically the employee gets the short end of the deal with out any bennies

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I am 1099, was working through an agency as a 1099 locum and then decided to do for myself what the agency was doing. I'm in Washington state. It has worked out well for me so far.

 

 

you are not a 1099 employee if you are using their equipement, their office, seeing their patients you will loose if you are audited by any state agency or the IRS - friend just went through it

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