ABOUT THE SURVEY….
- 362 readers responded to the survey.
- The survey results reflect averages, regardless of the number of responses received to each question. In a few cases, a low response rate may have affected the statistical outcome.
- The national figures reported in the overall results section of the survey are weighted by region, based on the relative number of respondents from the West, Midwest, South and East.
Editor’s Note: The results of this survey are for informational purposes only, and are not to be construed as a recommendation – implied or otherwise – on how you should set your fees.
General Survey Findings
Respondent Profile:
- Average Age: 42.9
- Age Range: 23-77
- Average No. of Years in Practice: 14.42
- Male: 83%
- Female: 17%
- Solo Practitioner: 82%
- Group Practitioner: 18%
- Multi-Discipline: 30%
Have you ever wondered how your fees and reimbursements stack up to your colleagues’? If so, you’ve come to the right place. Welcome to Chiropractic Economics’ Second Annual Fees & Reimbursement Survey. This comprehensive survey of the chiropractic profession will give you all the details on what your colleagues are charging – and what they get paid.
Thanks go out to our loyal readership for taking the time to share this important information. In all, 362 readers sent back the surveys that we distributed in May. We received input from Doctors of Chiropractic in 44 states. The respondents represent a wide variety of DCs, with demographic representation by region, age, years in practice, gender and type of practice.
We have broken down by code the average fees charged, the amount received and the reimbursement rate for a variety of common procedures. We have focused on a variety of CPT codes, under the categories of Professional Care, New Patient Exams, Radiology and Procedures and Modalities. The fees and reimbursement averages are reported on a national level, and are also broken down by practice type, gender, age, and region of the country. Where appropriate, we have compared this year’s statistics to those gleaned from our first-ever Fees & Reimbursement Survey completed last year (September 1998 edition of Chiropractic Economics). In addition, we have compared the fees and reimbursements of DCs with those of other doctors. We also address the forms of payment and terms you offer and your acceptance of credit cards and health-care cards.
If you have any questions or comments about this exclusive Chiropractic Economics survey, contact our Business and Editorial Offices at 904-285-6020. If you have any thoughts about fees and reimbursements and how the trends are affecting the chiropractic profession, please send your letter to the editor to Tara Stultz, Editor; fax: 440-234-2192; e-mail: tarastultz@aol.com; Chiropractic Economics, 13000 Sawgrass Village Center, Suite 18, Ponte Vedra Beach, FL 32082.
Respondent Profile
Gender, Age, Years in Practice
A total of 362 readers responded to this year’s Fees & Reimbursement Survey. Eighty-three percent of the respondents are male and 17% are female. That compares to 87% male and 13% female in Chiropractic Economics’ 1998 Fees & Reimbursement survey. The age range is 23-77, very similar to last year’s range of 23-79, with an average age of 42.9 (compared to 44.5). The breakdown by age is: 12% under 30; 22% aged 31-38; 27% 39-45; 28% 46-55; 10% 56 and up; and 1% did not respond. Last year’s breakdown was 10% under 30; 18% from 31-38; 25% 39-45; 29% 46-55; 14% aged 56 and up; and 4% did not respond. The average length of time respondents have been in practice is 14.42 years, compared to 16.24 last year.
Location, Location, Location
States, Regions, Suburban vs. Urban
The survey responses came from DCs in 44 of the country’s 50 states. Each major geographic region of the country is represented, broken down into the South, East, Midwest and West. The majority of the DCs practice in one state, but 10 have dual licensure, and one is licensed to practice in three states. Suburban practices are most common among this year’s respondents at 40.3%, followed by urban at 35.6 percent, rural at 21.3%. No response was received from 2.8%. The breakdown last year was: suburban, 35.4%; urban, 32.3%; rural, 24.1%; and no response, 8.2%.
Principle Form of Practice
Group vs. Solo, Multi-Discipline
Eighty-two percent of the respondents are solo practitioners, and 18% are in group practices. Last year, only 70% of the respondents were solo practitioners. Thirty percent report that they work in a multi-discipline environment, while last year, 32% did. Of the respondents who work in multi-discipline practices, the other disciplines besides chiropractic include: MD/DO (5%), massage therapy (27%), rehabilitation (11%) and dietitian/nutritional counseling (10%). Forty-three percent did not specify, and 4% worked in practices offering various services, such as acupuncture, psychology, podiatry, herbology, yoga, exercise physiology, physical therapy and homeopathy. Last year, the break down of disciplines in addition to chiropractic included: MD/DO, 10%; massage therapy, 24%; rehabilitation, 12%; and dietitian/nutritional counseling, 10%.
Payment and Terms
Revenue Sources, Credit Cards, Payment Plans
Not surprisingly, the most common forms of payment accepted are cash, at 98%, and checks, also at 98%, followed by: auto insurance, 93%; private insurance and Workers’ Compensation, both 90%; Medicare, 81%; major credit cards, 77%; managed care, 61%; Medicaid, 32%; and health-care credit cards, 15%. Last year’s breakdown was: cash, 95%; personal checks, 92%; Workers’ Compensation, 86%; private insurance, 83%; Medicare, 71%; major credit cards, 65%; managed care, 59%; Medicaid, 30%; and health-care credit cards, 18%. Eighty-two percent of the doctors accept credit cards, compared to 73% last year.
The cards accepted include: MasterCard, 74%; VISA, 73%; Discover, 43%; American Express, 27%; and the Care Credit health card, 5%. Last year’s breakdown included: MasterCard, 64%; VISA, 63%; Discover, 38%; American Express, 27%; and the Care Credit health card, 7%.
Sixty-four percent of respondents accept payment plans. Forty-two percent negotiate the terms on a per-case basis. The average terms offered are: 34% down with a 32-day billing cycle, with an average discount of 30% for cash. Last year, 55% reported that they offered standard payment plans, and 19% negotiated on a per-case basis. The average down-payment requested was 30%; the average billing cycle was 27.72 days, and the average discount for cash was 16.9%.
Office Visit Fees
What You Charge, What You Get Paid
Doctors of Chiropractic reported fees and reimbursements in the areas of Professional Care, New Patient Exams, Radiology and Procedures and Modalities, as illustrated on the charts on pages 44-45. We have calculated the average fees, reimbursements, and percentage reimbursed for your review. The averages are reported on a national level (overall response), as well as by region in the South, East, Midwest and West.
Compared to last year, the average fees charged for different CPT codes within Professional Care remained fairly stable. This year’s fees range from an average of $30.30 to $95.40, and last year’s fees were in the $30.09 to $87.70 range. Actual payments for Professional Care procedures this year range from $27.59 to $83.73; last year, the range was from $29.42 to $85.12. The rate of reimbursement is 84.44% to 92.35%; last year, it was higher, at 92.03% to 99.05%.
For procedures under New Patient Exam CPT codes, the average fees range from $71.50 to $134.58. Last year, that range was $66.90 to $122.36. Actual payments for new patient procedures range from $65.46 to $123.30. Last year, the range was $60.92 to $115.66. The percentage reimbursed this year is between 88.34% and 91.56%; last year, it was 91.06% to 94.52%.
Average fees for Radiology CPT codes ranged last year from $51.33 to $148.98; last year, the range was $47.09 to $131.60. Actual payments for Radiology procedures range from $45.93 to $128.44; last year’s range was $42.61 to $113.05. The percentage reimbursed is between 86.21% and 89.72%; last year, it was between 84.26% and 91.84%.
The following information examines some of the differences between the fees charged and the payment received for the CPT codes 99213 (established patient) and 99204 (new patient).
DCs’ Fees Compared to MDs’
For the Established Patient CPT code 99213, chiropractors charge an average fee of $51.94 and get paid an average of $47.97, for a reimbursement rate of 92.35%. In comparison, the median fee for all doctors (general practitioners, surgical specialists, non-surgeons, etc.), is $52.00, the actual payment is $40.00, and the reimbursement rate is 76.92%.
For the New Patient CPT code 99204, chiropractors charge an average fee of $102.39 and get paid an average of $92.38, for a reimbursement rate of 90.22%. In comparison, the median fee for all doctors is $119.00, the actual payment is $90.00, and the reimbursement rate is 75.63%.
For more specifics on DCs’ fees versus other doctors, refer to the chart on page 44 that compares Chiropractic Economics’ 1999 Fees & Reimbursement Survey with Medical Economics’ 1998 Continuing Survey, published Sept. 21, 1998.
Fees Around the Country
As mentioned above, the overall average fee that respondents charge for the Established Patient CPT code 99213 is $51.94, the actual payment is $47.97, and the reimbursement rate is 92.35%. Last year, the average fee charged was $48.27, the actual payment was $44.06, and the reimbursement rate was $91.28%. The reimbursement rate for CPT code 99213 by region is: Southern Region, 89.90%; Eastern Region, 80.92%; Midwestern Region, 90.39%; and Western Region, 93.74%.
Also, as mentioned above, the overall average fee that respondents charge for the New Patient Exam CPT code 99204 is $102.39, the actual payment is $92.38, and the reimbursement rate is 90.22%. Last year, the average fee charged was $92.22, the actual payment was $85.46, and the reimbursement rate was $92.68. The reimbursement rate for CPT code 99204 by region is: Southern Region, 88.24%; Eastern Region, 86.60%; Midwestern Region, 83.86%; and Western Region, 83.45%.
Age Differences
For Established Patient code 99213, DCs 56 and up charged the least ($48.64) but received the highest reimbursement rate, at 97.09%. DCs 39-55 charged an average of $54.15 and had a reimbursement rate of 91.33%; DCs 38 and under charged $49.49, with a reimbursement rate of 92.16%.
For New Patient code 99204, DCs 56 and up charged the most ($105.71) but received the lowest reimbursement rate, at 79.13%%. DCs 39-55 charged an average of $103.53 and had a reimbursement rate of 91.30%; DCs 38 and under charged $100.56, with a reimbursement rate of 90.09%.
Gender Differences
For Established Patient code 99213, male and female Doctors of Chiropractic charge almost exactly the same fee – $51.94 for males, and $51.95 for females. However, female DCs receive an average actual payment of $46.14 for a reimbursement rate of 88.79%, while male DCs receive an average actual payment of $48.33, for a reimbursement rate of 93.05%.
For New Patient code 99204, female Doctors of Chiropractic charge less than male DCs, but they receive a higher reimbursement rate. Female DCs charge an average of $96.06 and receive an actual payment of $87.78 for a reimbursement rate of 91.38%. Male DCs charge an average of $103.66 and receive an actual payment of $93.07 for a reimbursement rate of 89.78%.
Solo vs. Group Practices
Doctors of Chiropractic in solo practice charge an average of $52.31 for Established Patient code 99213; these doctors receive an actual payment of $48.15, for a reimbursement rate of 92.06%. Group practice Doctors of Chiropractic charge an average of $50.34 and receive an actual payment of $46.11, for a reimbursement rate of 91.60%.
DCs in solo practice charge an average of $102.39 for New Patient code 99204, and they receive an actual payment of $91.96, for a reimbursement rate of 89.81%. Group practice DCs charge an average of $104.84 and receive an actual payment of $94.29, for a reimbursement rate of 89.93%.
