Contract/Per Diem Cardiac Sonographers: Need tax advice

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dkocheran in Vista, California

79 months ago

Hi Renee:
You may be the person who got my job in oceanside and one of the reasons I left. Most independents get $50-55 for echo and up to $75 for Stress. I know techs getting $42 and hour working for physicians. $45 is
too low being a independent contractor. The percent to put money aside for taxes is 30%.. My husband has his own company and he told me that that is a true percentage . When you are a self contractor and not an employee you are paying the entire tax on the Fed. state, medicare,and SS tax instead of an employer who would pay 1/2 your tax deductions for you, workmans compensation is not covered if the contract you sign has a waiver in it, no vacation time, sick time, 401K, or holiday pay. That's alot of money to not get.

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studentnurse in Long Beach, California

77 months ago

does anyone know of any echo schools in southern california

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dkocheran in Vista, California

77 months ago

studentnurse in Long Beach, California said: does anyone know of any echo schools in southern california

Yes there is a school in orange county and one in san diego. I think the one in orange is called orange coast school of ultrasound. And the one in San diego is at Grossmont college.

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Pat Guest in Greenwood, Indiana

77 months ago

dkocheran in Vista, California said: Hi Renee:
You may be the person who got my job in oceanside and one of the reasons I left. Most independents get $50-55 for echo and up to $75 for Stress. I know techs getting $42 and hour working for physicians. $45 is
too low being a independent contractor. The percent to put money aside for taxes is 30%.. My husband has his own company and he told me that that is a true percentage . When you are a self contractor and not an employee you are paying the entire tax on the Fed. state, medicare,and SS tax instead of an employer who would pay 1/2 your tax deductions for you, workmans compensation is not covered if the contract you sign has a waiver in it, no vacation time, sick time, 401K, or holiday pay. That's alot of money to not get.

Hi, ? I have a friend in California who is a top-notch vasuclar tech and abdominal tech and is looking in to becoming more versed in echocardiography. Do you know anyone who might let her shadow or would you be willing to train her for a fee?
Let us know.
Sincerely,

Pat Guest
pguest1@sbcglobal.net
kattems@yahoo.com

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gina2009 in Detroit, Michigan

74 months ago

What if you are bring your own ultrasound mobile machine? Is the going rate per echo still $55 per patient?
Does anyone know if you should be paid more and if so, how much per exam?

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Diane Kocheran in Vista, California

74 months ago

gina2009 in Detroit, Michigan said: What if you are bring your own ultrasound mobile machine? Is the going rate per echo still $55 per patient?
Does anyone know if you should be paid more and if so, how much per exam?

Dear Gina:
I work in the San Diego area which is one of the lower paying areas in the country. I think we have a sunshine tax or something.
But I did a lot of research regarding echo techs and being contracted versus employee. If you own your own equipment, bring your own supplies, schedule your own times and days you are truly an independent contractor. According to the EDD (Employment Develop Department). You must be able to make a profit or loss. Techs being paid by the patient and working in offices where they own their own equipment and everything else you are classified as an employee and your employer should be taking your taxes and paying into unemployment and workmans comp in case you get hurt. Owning your own equipment you should get the technical component when the doctor bills insurance. Look up CPT codes for Cardiac Echoes. I know in CA that the technical gets paid the most. Echoes get reimbursed by medicare (the lowest) around $340. The professional fee (Doctor reading) gets around $80 of that. If you are only getting $55 you should be making way more than that. You own the equipment and have to maintain it plus you do all the work.
You should be making double?
Diane Kocheran

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Douglas Pereira in Long Beach, California

74 months ago

Does anyone know how the echocardiographer job market is in Long Beach? I'll be attending OCC's CVT program in a while. My cardiologist mentor introduced me to echocardiography by showing me images, and I was totally fascinated by it, and cardiology in general. I had an almost fatal heart problem when I was born, but thanks to the ECHO they found the PDA, and cured it w/ indomethacin. I hope to become an interventional cardiologist or electrophysiologist some day.

I plan on financing the purchase of my own portable machine and transducer and starting a private practice (contract with hospitals like LB Memorial and Community) after I graduate, get RDCS, and a year or two of experience.

If my calculations are correct, since an ECHO takes around 45 mins to perform, in an 8 hour day I could perform 10 ECHOs, and at $340/exam (the SonoSite website's reimbursement page says $195.84/exam, but Ms Kochran said $340/exam; why the discrepancy?), I could take in revenue of $3400, or $884,000. I'd probably take in a lot less then that, right? Am I totally out of my mind with these figures?

What would my expenses be? Equipment and malpractice insurance, payments on the equipment, medical billing fees, transportation, equipment maintainence, health insurance, etc.? I suppose those would be at least $150,000/year. What tends to be your profit margin?

How many TEEs/week do you tend to perform, and how are they reimbursed?

Thanks for the help,
Doug

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Diane Kocheran in Vista, California

74 months ago

Hi Doug:
Sonolite website
CPT code 93307 complete echo = $191.96.
Add also CPT code 93320 for Doppler = $84.93
Plus the CPT code 93325 for Color + 79.22

Total reimbursement $356.11 for echo to physician 2008

Technical fees reimbursed $285.65. That would be the tech and their machine.

Professional fee ( reading) $70.46
Why cut yourself short with your fee's if you own the equipment?
All the CPT codes I listed are the ones the doctor uses in his office. I have been in this business 32 years. I think echo techs are very underpaid. Stress echoes get reimbursed around $600 and I am not sure about TEE's.

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steven c. in Miami, Florida

74 months ago

The only problem with that is you do 1-2 days a week usually. And you get 35-45 per study in my neck of the woods. Its very over saturated here as theres many schools (8-10). you do make money but not the amount you came up with, here its around 40-60k

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Diane Kocheran in Vista, California

74 months ago

Dear Doug:

You would want to charge the Technical component only unless you have cardiologist reading them. Remember you would have to pay the reading physician then.

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Diane Kocheran in Vista, California

74 months ago

I agree with Steven. It's hard to get enough work unless you are traveling all over the place. Don't forget Gas prices here .
Being independent you also have to pay for your own Medical insurance unless covered under a spouse. No workmans comp, no sick or holiday pay, no paid vacations. It sucks.

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Douglas Pereira in Long Beach, California

74 months ago

Should I bill 93307+93320+93325 (pays me more, so I'll do that), Why do we have both that combo AND 93306? Discussing CPT codes make us sound like the LAPD, doesn't it?

Btw, those fees are out of date; 2009 is a bit lower: www.sonosite.com/downloads/reimforms09_ECHO.pdf

And the Medicare fees for my area are much higher then what Sonosite says, and a little higher then what you say; www.cms.hhs.gov/PFSlookup/02_PFSSearch.asp

So, based on these payments, by performing 10 scans/day, 5 days/week, 50 weeks/year, I could take in revenue of $718,475/year. I guess this is why so many doctors want to perform their own imaging.

Once again, someone please tell me if I am out of my mind; most self-employed echo techs don't make this much in revenue, do they?

(I searched by carrier, selecting SoCal)

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Douglas Pereira in Long Beach, California

74 months ago

steven c. in Miami, Florida said: The only problem with that is you do 1-2 days a week usually. And you get 35-45 per study in my neck of the woods. Its very over saturated here as theres many schools (8-10). you do make money but not the amount you came up with, here its around 40-60k

OK, that sounds a lot more reasonable...I'll be able to earn my BS as well.

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Douglas Pereira in Long Beach, California

74 months ago

Diane Kocheran in Vista, California said: I agree with Steven. It's hard to get enough work unless you are traveling all over the place. Don't forget Gas prices here .
Being independent you also have to pay for your own Medical insurance unless covered under a spouse. No workmans comp, no sick or holiday pay, no paid vacations. It sucks.

I'm willing to take that risk.

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Douglas Pereira in Long Beach, California

74 months ago

Diane Kocheran in Vista, California said: I agree with Steven. It's hard to get enough work unless you are traveling all over the place. Don't forget Gas prices here .
Being independent you also have to pay for your own Medical insurance unless covered under a spouse. No workmans comp, no sick or holiday pay, no paid vacations. It sucks.

No pain, no gain.

Would it be wise to hire echo techs, and basically have my co. contract w/ offices and hospitals, place a tech for the duration of the contract, pay that tech $40/hr, and collect the technical component of the scans?

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Douglas Pereira in Long Beach, California

74 months ago

Douglas Pereira in Long Beach, California said: No pain, no gain.

Would it be wise to hire echo techs, and basically have my co. contract w/ offices and hospitals, place a tech for the duration of the contract, pay that tech $40/hr, and collect the technical component of the scans?

And lease a machine for them, of course.

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Marlene Dodson in Fremont, California

73 months ago

dkocheran in Vista, California said: Yes there is a school in orange county and one in san diego. I think the one in orange is called orange coast school of ultrasound. And the one in San diego is at Grossmont college.

There is also one in Ventura ..The Institute of Cardiac Sonography..they also teach Vascular

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trixray in trenton, New Jersey

73 months ago

Can someone tell me whether or not charging $40 per study is compensation enough for general ultrasounds mostly on small parts (i.e. thyroid)? This is in an endocrinologist's office, they have the equipment and do all the leg work? This is in the Pa area.

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dkocheran in Vista, California

73 months ago

trixray in trenton, New Jersey said: Can someone tell me whether or not charging $40 per study is compensation enough for general ultrasounds mostly on small parts (i.e. thyroid)? This is in an endocrinologist's office, they have the equipment and do all the leg work? This is in the Pa area.

I work for an Endocrinologist in Oceanside CA. I get paid $35 per echo but I also type the report. It's in a report form template but I do have to put in all the measurements. If you can get $40, go for it. Remember when you are an independent contractor, you don't get workmans comp, employment insurance in case you get fired or laid off ,and you only get 1/2 of SS and medicare payments because your employer isn't paying for their half. It will matter when you get older. In CA, we get paid less than the east coast because we have a sunshine tax I think. Good luck, remember you are worth it. I would also check what medicare is reimbursing for studies. In CA the doctor only gets $80 for the technical and professional fee.

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trixray in Trenton, New Jersey

72 months ago

dkocheran in Vista,
Is the template that you utilize when you do your ultrasounds one that is in the machine's software or one that you made up on your own? The doctor wants me to have a format or template of all the tests (general u/s's) that are performed. I have no example of a common template so that i can make one up.

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dkocheran in Vista, California

72 months ago

trixray in Trenton, New Jersey said: dkocheran in Vista,
Is the template that you utilize when you do your ultrasounds one that is in the machine's software or one that you made up on your own? The doctor wants me to have a format or template of all the tests (general u/s's) that are performed. I have no example of a common template so that i can make one up.

Hi:
Are you asking about a report form or a worksheet form? If you are talking about a report form, ask the doctor to show you what he wants. If its a worksheet to give him, that accompanies your studies. Ask him to get you one from the hospital where he works.
My doctor made up his own and its stored on the computers in the office. When I go and do my thyroid studies, I use their computer in the room I do ultrasounds in with the template stored on that computer

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trixray in Philadelphia, Pennsylvania

72 months ago

The doctor does have a template for vascular studies that the rep put in but none for general u/s. But, in the manual for the machine you're supposed to be able to make your own template. So, as soon as the rep helps me figure out how to do it for one , I will able to make up the rest as I go along.
The machine is the MINDRAY M5, does anyone have any input they want to share?

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alka patel in farmington hills, Michigan

71 months ago

gina2009 in Detroit, Michigan said: What if you are bring your own ultrasound mobile machine? Is the going rate per echo still $55 per patient?
Does anyone know if you should be paid more and if so, how much per exam?

Hi, Gina
My name is alka. I am from detroit area. I am looking for some part time contract work. If you know of anything please let me know.
Thank you

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mishelle31 in Los Angeles, California

68 months ago

I go to west coast ultra sound for echo sonography.Whats my chances of getting a job? Does anyone know whos taken this route.It is a 1 1/2 year program.And they do intership but this is all new to me..

Im paying like 37,000 so kind of curious about what I need to know.Thanks

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nICOLE in Oceanside, California

68 months ago

HOW MUCH SCHOOLING IS NEEDED? AND ANY PRE REQUISTITES?

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Mel in Houston, Texas

67 months ago

echo reimbursements from medicare before january 2009 were $360. after january 2009 they were $260. then the government cut again in 2010 10% a year for 4 years. so by the year 2014 echo reimbursements will only be about $160/ per echo. so people getting paid $50-55/study a couple of years ago can kiss that goodbye. i seriously doubt any doc will pay you 1/3 of what they make. i work in houston and do contract and know plenty of contract sonographers and doctors are cutting prices. so i would imagine $40-45 an echo will probably be what it comes down to. maybe even lower. my taxes are around 25% a year. i work part time at a hospital too for benefits. most hospitals pay $25-30/hour. i can predict what will happen...the pay cuts will get worse. and the pay for contract will get quite similar to what you would make at a hospital while doing many more studies. people will stop wanting to do contract and then move towards hospitals. then hospital jobs will be harder to find with increased competition.

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Mel in Houston, Texas

67 months ago

dkocheran in Vista, California said: I work for an Endocrinologist in Oceanside CA. I get paid $35 per echo but I also type the report. It's in a report form template but I do have to put in all the measurements. If you can get $40, go for it. Remember when you are an independent contractor, you don't get workmans comp, employment insurance in case you get fired or laid off ,and you only get 1/2 of SS and medicare payments because your employer isn't paying for their half. It will matter when you get older. In CA, we get paid less than the east coast because we have a sunshine tax I think. Good luck, remember you are worth it. I would also check what medicare is reimbursing for studies. In CA the doctor only gets $80 for the technical and professional fee.

theres no way a doc is only getting $80 per study. they are definitely telling you a lie. they get around $230 as of today. it was $260 last year.

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nevfive in North Royalton, Ohio

67 months ago

what report template are you using? We type reports as well and have been lookng for a good report template.

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dkocheran in Vista, California

67 months ago

Mel in Houston, Texas said: theres no way a doc is only getting $80 per study. they are definitely telling you a lie. they get around $230 as of today. it was $260 last year.

I was referring to thyroid ultrasound studies, not echocardiograms. Sorry.

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CF in Peterborough, Ontario

65 months ago

How do I get these jobs, I am looking for some extra work a few days a month and want to look into working per case in the states. Any advice or contact numbers that I can reach?

Thanks

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echotech in Brooklyn, New York

65 months ago

Mel in Houston, Texas said: theres no way a doc is only getting $80 per study. they are definitely telling you a lie. they get around $230 as of today. it was $260 last year.

does anyone know the going reimbursement for echos in the NY area? or how i can find them out?

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dkocheran@cox.net in Encinitas, California

64 months ago

I was talking about thyroid ultrasound exams not echoes.

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charu in East Brunswick, New Jersey

62 months ago

I am an echo tech and as an independent contractor my docs pay me only $35 per study. They tell me they make a lot less this year than last year. Can some one tell me how much BCBS pays for 93306?

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joe in Santa Clara, California

62 months ago

i don't care how much they lost last year, you are getting ripped off, just look at how much medicare pays. go to the website

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sopalaci in Houston, Texas

61 months ago

I am echo-tech, RDCS, with 10 tears of experience. How can I get jobs to travel uder 3 or 6 onths contract? Thank you!

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charu in East Brunswick, New Jersey

61 months ago

I have over 20 years. I want to do some work in other states short term like you. I hope we find something.

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1cag1 in Oshawa, Ontario

53 months ago

Hello, I am looking into purchasing my own echo machine and preforming my own echocardiograms in the states.As i am working like an animal and am significantly underpaied. Any one out there who has done this please pass along your contacts as I need advice and guidance.

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charu in East Brunswick, New Jersey

53 months ago

I know it is not easy in the US. Insurance forms need to be filled out and you need pre certifications for the procedure. It is best to work in a doctors office and have them do the work and get paid per study. S

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1cag1 in Oshawa, Ontario

53 months ago

Maybe you can still help me. I am feeling overworked and under paid. I want to find a position somewhere in the states where I can be paid per diem and work on a contract basis, fly in one or two weeks a month. Know anyone who does this?

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charu in East Brunswick, New Jersey

53 months ago

I do not know anyone who will give a position for a few weeks. I retired last Dec after working in an office for 20yrs. The hospitals here may have per diem positions but they will only accept applications online. Your best bet is to try to find a hospital position and make contacts with doctors who want echoes done in their office. All the best. S

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ultrasoundjoe in Cupertino, California

53 months ago

dude, it's tough, email me so we can talk on the phone....ultrasoundjoe@gmail.com

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ultrasoundjoe in Cupertino, California

53 months ago

look it up online, damn

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Leisa in Orlando, Florida

50 months ago

Can anyone tell me how much to echo techs make in Orlando and would it be better to do Sonagraphy to learn about all of the organs in your body or just the heart. Also, what accredidations do you need for Cardio tech. Is it the same as a Sonographer?

Thanks and please let me know of any other medical fields that are good to go into. I am in my 40's and starting my career over so I don't have alot of time to waste.

Thanks

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jpadilla619 in Carlsbad, California

42 months ago

Hi, I just got my passed my RCS test, any of you know anyone that is hiring for independent contract work as an ECHO Tech in SOCAL area. I am from Carlsbad and have over 2 years experience. Please let me know if you know anyone that is hiring? Thank you.

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eddeduyo in Tustin, California

38 months ago

studentnurse in Long Beach, California said: does anyone know of any echo schools in southern california

PACIFIC COLLEGE IN COSTA MESA CA

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Lacey in Jasper, Georgia

19 months ago

I am doing research for a project and i need to know what benefits are provided

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