wRVU incentive with split/shared and incident-to services

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  • Avatar MDbooks 
    Status: Physician
    Posts: 3
    Joined: 05/17/2019
    Splash Refinancing Bonus

    I am currently negotiating a contract for a hospital-employed Cardiologist position (coming out of fellowship). They are offering a wRVU incentive with a threshold and compensation/wRVU set at MGMA median for the geographic region. My questions is regarding split/shared billing for inpatient consults and incident-to billing in the clinic as they have PA’s in the clinic and on inpatient consults. Should all wRVUs generated from billing under my NPI be attributed to me for the purposes of the wRVU incentive? If not, how should this be split? They have hinted that this will somehow be split but we have not yet discussed the details. Would like to know what to expect going into this discussion. Appreciate any insight you can provide as I don’t have any experience with this and do not know what the norm is.

    #219674 Reply
    Avatar Tim 
    Status: Accountant
    Posts: 3030
    Joined: 09/18/2018

    I think your question concerns more than your compensation. The coding guidelines of Medicare and insurance carriers will come into play.

    Anecdotally, folks here have commented that miscoding occurs and you need to “trust but verify “. It seems to be specialty specific.

    Regarding MGMA median for your region. These are just averages, a good starting point. Your focus needs to be on total comp appropriate for your particular hospital. Make sure you are comfortable with the total that you position will actually deliver. The total comp is the geographic arbitrage. Median wrvu’s and rates vary and easily are different. If the median for your hospital is way below the regional average, well you know the result if you don’t up the rate. Data counts, but understand how that translates into you pay, down to the split billings. You are on the right track, translating median into your paycheck.

    Hope one of the Cardios can answer the split question.

    #219706 Reply

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