Questions for Dr. Stern
About Your Urgent Care Center
8. I saw your article in the JUCM, and I was wondering if you could help with a question. I am currently developing a pro-forma for a startup urgent care that we are considering. Do you know the CPT codes used to bill the office visits? Also what is the reimbursement for these codes?
Actually, code-based pro-formas are generally not very useful. I usually suggest that you use about $100 or $110 per patient visit as a good estimate (fairly conservative) of reimbursement. The actual codes and code reimbursement is not that useful, as your number one variable in monthly revenue and monthly reimbursement is number of patients seen. This can vary by the end of the first month from 5 patients per day to 45 patients per day. As you can see, it doesn’t really matter what exact number of dollars you predict for each patient. The key issue is HOW MANY PATIENTS WILL YOU SEE. The bad news here is that this is highly variable, and even after opening 13 urgent care centers, our team is often surprised by the numbers (by factors of 2-4).
