96110 Reimbursement Followup

As promised, here's a followup to my 96110 data from the other day. It's interesting to see how 96110 usage has increased in pediatricians over the years, but what are folks getting paid? Here's the data:


I know it's hard to read, so click here or on the image to see the entire thing.

So, what do we learn? Back when the 96110 was rarely used by pediatricians, it was paid pretty well ($50+). However, in 2004, CMS first published RVUs for the code and the average reimbursement plummeted. Today (and 2008 projects the same), the average payment is often between $14 and $15...or right about 100% of Medicare for most folks. Given that this is a service many of you already perform - and all of you should! - it's nice to get reimbursed at all in today's climate. Frankly, 100% of Medicare is right in line with average pediatric reimbursement in general - sad, but true - so this looks like it should slip right into the daily expectation of your well visits, etc.

In order to see the total effect of 96110 income on a pediatric practice, compare this with the previous graph...if the average PCC client (who uses this code) recorded 1800+ of them in 2007, that's almost $30,000. Add to this Dr. Stoller's message (and, yes, you too, Dr. Cain!), and you're talking about lots of potential income. Enough to make the effort. What are you waiting for, agian?