How to Get Paid 360K/year Taking Care of 300 Patients

Mrs. Smith was livid, I had given her sister bragging rights over her and she was greatly displeased.


Mrs. Smith had called the office requesting I come see her for a house call and then “went off” on my great staff when I refused.


I had done one for her sister days before. Her sister was homebound from a stroke and I, new in town, saw her at home for a visit in an effort to generate word-of-mouth.


It certainly worked—too well.  The phone was ringing off the hook asking for the doctor who would see them in their homes the way their doctor did when they were a kid.  And when we had to turn them down, they were not happy.


I think I alienated as many patients as I acquired.


Back then, Medicare would only cover house calls if the patient was so infirmed as to be unable to leave the house.  If you were healthy enough to travel, you were healthy enough to see the doctor.


When Medicare Advantage came on the scene, the rules were the same—you couldn’t submit codes from a house call unless the patient qualified under Medicare rules.


Such regulations made it very hard to run a “house call only” Medicare Advantage practice. Home bound patients were extremely ill, extremely costly and unlikely to survive long enough for their risk-codes to come online and recover your costs.


That was then. This is now.


If the proposed changes to CPT coding in 2020 go through, any Medicare or Medicare Advantage patient can qualify for a house call.


No need to document a condition that prevents them from leaving the home—they will no longer need one to qualify.


House call-only Medicare Advantage practices can be a reality.


A physician or autonomous NP can pretty easily set up and run their own Medicare Advantage house call-only practice.  With little overhead, you could very easily generate a net of $100 pmpm from an off-the-shelf Medicare Advantage contract.


For a panel of 300 patients, that’s 360k per year. For an average of one visit a day.


How much are you earning?


What are you doing to earn it?


What is your time worth?