Be Smart Volume 1: How will you get paid?

getting paidThe stickiest and trickiest part of any interview process is often the discussion of how much you will be paid. This part can be intimidating, even for the most experienced professional. Don’t be afraid to ask questions. Voice your concerns! If you don’t bring up your concerns for fear of being ridiculed or sounding inexperienced, you will regret it later on down the road.  There are several questions you can ask to protect yourself and make sure you’ve got a clear understanding of what you’re about to get into, all while landing yourself a fair deal.

Billable Hour Billable hour is cut and dry. Therapists who are paid based on billable hour are only paid for time when they are actually billing Medicare/Insurance. Using this method, there is no time allotted for trainings, documentation, in-services, travel, etc… thus leaving new grads or therapists who are in a supervisory role at risk for being in the facility but off the clock in order to get the job done effectively.   Here are a few things to think about: Are you allowed overtime? And will someone provide support if you have more than 8 billable hours? Will you be required to work longer days?  In a billable hour scenario, your annual income is based solely on how much time you are billing for patient care. This can place the therapist in a dilemma if caseloads are low and the demands of the facility are high; time spent on screening and paperwork do not count toward your take home pay.  This model can cause friction between therapists and assistants if loads are not high and both a therapist and an assistant are assigned to a building.

Salary This may be your best bet if caseloads tend to vary. Ask about caseloads in your potential facility. What is the average? If the load gets low, are you required to fill in somewhere else? If the load gets high, will you be given any help? Evaluate the salary carefully and ask several questions.  There are definitely pros and cons in any payment structure. The pros regarding salary would be consistent paychecks on a regular basis; therapists are not penalized for drops in caseloads that are beyond their control. These dips are typical during certain times of the year (summer months and around holidays in home health and outpatient settings).  Here are a few things to think about: What are regular work hours? And what other locations are available within a reasonable drive in the event that your caseload drops?  Salaried positions should afford the most flexibility and consistency, but here are the cons. Salaried positions may not offer the highest pay if compared to an hourly rate based on billable hour or productivity. Because the salary is guaranteed and your employer knows there will be inevitable dips in caseload, the salaried position is a safe bet and a happy medium for all parties involved.

Productivity Standard – Here are some things to think about: Does productivity play a part in how you will be paid? Is there a productivity standard and does it directly impact your salary? Find out. Most contract therapy providers, clinics, and hospitals pay their therapists based on productivity. Productivity looks at your billed time for a given day and divides that time by your total time in the facility.  Many companies expect 90% productivity. This may be difficult considering large volumes of evaluations and discharges, not to mention the meetings, trainings, possible traveling, and in-services that are expected of the employee. Pros: considering you have a great caseload all year long and you work a full 8 hour day, 5 days per week, 52 weeks per year, your income calculation will look very good on paper. Cons: remember those inevitable dips in caseloads that I mentioned above? It is unlikely that your caseload will remain that high all year long. While your productivity may remain at 90%, you may not have enough work to warrant your presence in the facility for a full 8 hours.  Which brings up a whole new set of concerns…deal

Will you ever be sent home early due to a low case load? What happens if so? Are you able to make up those hours at another facility or at another time? Can you use your paid time off? If this happens often, what will happen when you run out of PTO or want to take a vacation? Speaking of vacation, who will cover for you when you are sick or are on vacation? And who makes arrangements for that coverage, are you responsible for finding your own coverage?

You’re probably thinking that this sounds like a lot of questions. Please review my advice on asking questions HERE. Voicing your concerns will indicate that you mean business. This is a sensitive topic and you definitely want to have a crystal clear understanding of how you will be paid.  After all, that is what an interview is all about, right?

Interested in a career with Therapy Center? Take a look at Therapy Center Success Stories to see how our therapists are impacting the lives of their patients and making the road to recovery a success!

Did you find this blog topic to be helpful? If you have questions or comments please feel free to contact Therapy Center Recruiter, Ava Hebert at


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