Issue 12 - September, 2003

Special Report - Sixth Annual Fees & Reimbursements Survey Results
How do your fees and reimbursements compare?
Our Sixth Annual Survey gives you a benchmark
By Linda Segall

Curiosity may have “killed the cat,” but it can serve you well when it comes to setting fees: Set them too high and you may price yourself out of the economic reality of your patients. Set them too low and you undervalue yourself and what you contribute as a healthcare provider.

The only way to know if you are setting fees at an appropriate level is to have information available that allows you to compare.

In May and June, we contacted readers by e-mail and through ChiroEcoNewsflash.com and invited you to participate in our Sixth Annual Fees and Reimbursements Survey. Practitioners, associates, CAs and students in all but two states (Rhode Island and Vermont) took the time to complete the survey.

The results of the survey will allow you to answer some questions that may be on your mind:

• “What do colleagues in my area of the country charge?”

• “Are fees in my region of the country higher or lower than the national average?”

• “Does age have an impact on fees?”

• “ Is there a difference in fees and reimbursements between male and female chiropractors?”

• “Are fees higher — or lower — in multi-discipline practices?”

What did our survey tell us?

• A record response. This year a record number of respondents — 608 — took the time to answer our confidential survey questions.

• Nationwide response. Respondents hailed from 48 of the 50 states. Only Rhode Island and Vermont are not represented in the totals.

Although all regions of the country were well represented, fewer respondents came from the East (20.0 percent) than the South (28.5 percent), West (27.3 percent) or Midwest (24.2 percent).

• All ages. The average age of our respondents was 42.2. However, respondents ranged in age from 24 to 72. And, on average, they have been practicing for 12.6 years.

• More women. Previous surveys conducted by Chiropractic Economics have shown that approximately 14 percent of chiropractors are women (see “How do you compare?” Chiropractic Economics’ Sixth Annual Salary and Expense Survey, Issue 6, May 2003.) This survey, however, had a larger percentage of female respondents — 21 percent; 87% of female respondents were chiropractors.

• Solo practice prevails. We asked respondents to identify if they were solo practitioners (that is, the only doctor of chiropractic in their clinic) — with no other disciplines (such as massage therapy, medicine or physical therapy). Approximately 73.2 percent are solo practitioners. Of these, 43.6 do not have another discipline in their practices while 29.6 percent use another discipline in their clinics.

Approximately 26.8 percent of respondents are in some type of group practice. Of these respondents, approximately 15.9 percent are involved in a group practice with another discipline and 10.9 percent are not.

Viewed in another way, 45.5 percent of the respondents — whether solo practitioners or in a group practice — are involved in a multi-discipline practice, which may or may not involve a medical doctor.

• Suburbs most popular. Practicing in the suburbs attracts 46.7 percent of respondents, while 32 percent have clinics in urban environments and 21.3 percent practice in rural areas.

• Average reimbursements. Reimbursement rates vary according to procedure, and range from a low average rate of 62.7 percent for 97010 (hot or cold packs) to a high average of 86.2 percent for 99202 (E and M service for established patients). The overall average reported reimbursement rate is 79.5 percent.

Noteworthy changes
To make the survey as pertinent as possible, we reviewed codes and eliminated some used in previous years and added others that are more relevant to today’s practices. We also did a comparison to last year’s survey results (see Archived Articles 2002, October, on our Web site, www.ChiroEco.com), whenever feasible. We found some noteworthy changes:

• Fees, reimbursements are up. Overall averages show that both fees and reimbursements are up from 2002. The overall average fee charged in 2002 was $59.07; in 2003 it was $61.07, representing a 3.4 percent increase. Reimbursements rose slightly more. In 2002, the average reimbursement was $45.95; in 2003, it was $48.54, for an average increase of 5.6 percent.

• Biggest increases in fees. Among all the fees included on the survey, 99204 (O.V. w/comprehensive history and exam with moderately complex treatment decision) experienced the largest average increase in fees. In 2002, the average fee for this code was $109.23; in 2003, it was $136.93 — an increase of 25.4 percent.

Although the reimbursement rate for this code decreased from 87.8 percent in 2002 to 84 percent in 2003, the average fee collected rose to $114.98, compared to $95.90. Because of the higher fees charged, the actual change in reimbursements was a 19.8 percent increase.

• Largest decrease in fees. Not all fees increased; some experienced significant average decreases. For example, in 2002, respondents reported an average fee of $63.85 for 97124 (massage). In 2003, this fee was $36.61, presenting an average reduction in fees of 42.7 percent. However, in 2002, the code was reimbursed at an average of 40.8 percent ($26.05). In 2003, massage was reimbursed at a rate of 76.3 percent for an average collection of $27.93 — an average reimbursement increase of 7.2 percent.

• Biggest increase in reimbursements. A significant increase in reimbursements was given to 99054 (Sunday and holidays). Fees increased by a modest overall average of 5.5 percent. However, actual average reimbursements increased by 48 percent, from $32.27 (55.2 percent rate) in 2002 to $47.77 (77.5 percent rate) in 2003.

• Largest decrease in reimbursements. Some fees and reimbursements suffered over the course of the last year. Most notable was 98943 (extra spinal radiology, one or more regions). In 2002, the average fee was $35.28, which was reimbursed at 87.8 percent. In 2003, the average fees dropped to $34.56 and — more significantly — the average reimbursement for this code was reduced to 77 percent. Because of the lower average fee charged and the lower reimbursement rate, the actual average reduction in reimbursements was 24.5 percent from the previous year.

Linda Segall is editor-in-chief of Chiropractic Economics.This information is provided for informational purposes only and are not to be construed as a recommendation — implied or otherwise — on how to set fees.