Cost and Revenue Glossary

Provider Expenses:

Advanced Practice Provider (APP)

Also referred to as: Advanced practice practitioners, nonphysician providers (NPPs), physician extenders, mid-levels, etc.
 

Advanced practice providers are specially trained and licensed providers who can provide medical care and billable services. Examples of advanced practice providers include audiologists, certified registered nurse anesthetists (CRNAs), dieticians/nutritionists, midwives, nurse practitioners, occupational therapists, optometrists, physical therapists, physician assistants, psychologists, and surgeon’s assistants.

NOTE: Residents are not considered advanced practice providers in MGMA datasets

Provider

Both physician and advanced practice providers (APP) that provide medical care and billable services.

Included:

• Practice providers such as shareholders/partners, salaried associates, employed and contracted providers, and locum tenens;
• Residents and fellows working at the practice; and
• Only providers involved in clinical care.

Not included:

• Full-time provider administrators or the time that a provider devotes to medical director activities. The FTE and cost for such activities are included as "General administrative.”

Total provider cost

The sum of “Total advanced practice provider” and “Total physician” costs.

Total physician cost

The sum of “Primary care physicians,” “Nonsurgical specialty physicians,” and “Surgical specialty physicians” costs.

Total physician compensation cost [8110-8116, 8119, 8210-8216, 8219, 8310-8316, 8319, 8610-8616, 8619]¹¹

The total compensation paid to physicians.

Included:

• Compensation for shareholders/partners, associates on salary, employed physicians, contract physicians, locum tenens, residents, and fellows;
• Compensation for full-time and part-time physicians;
• Provider wages reported as direct compensation in
  • Box 5 on the W2.
  • Box 7 on the 1099.
  • Box 1 plus Box 4 minus Box 12 minus Box 13 from the provider’s K-1 form 1065.
  • Box 5 (Medicare wages and tips) from the providers W-2 plus Box 1 minus Box 11 minus Box 12 from the provider’s K- 1 form 1120S.
• Bonus and/or incentive payments, research stipends, honoraria, distribution of profits;
• Voluntary employee salary deductions used as contributions to 401(k), 403(b),or Section 12 plans; and
• Compensation attributable to activities related to revenue in “Nonmedical revenue.

Not included:

• Amounts included in “Total physician benefit cost,” Cost column;
• Provider consultant cost;
• Expense reimbursements;
• Fringe benefits paid by the medical practice (such as retirement plan contributions, life and health insurance, automobile allowances); or
• Any employer contributions to a 401(k), 403(b), or Keogh Plan.

Total physician benefit cost [8117-8118, 8120-8180, 8217-8218, 8220-8280, 8317-8318, 8320-8380,8617-8618, 8620-8680]¹¹

The total benefits paid to physicians.

Included:

• Employer’s share of Federal Insurance Contributions Act (FICA), payroll, and unemployment insurance taxes;
• Employer’s share of health, disability, life, and workers’ compensation insurance;
• Employer payments to defined benefit and contribution, 401(k), 403(b), and nonqualified retirement plans;
• Deferred compensation paid or expensed during the year;
• Dues and memberships in professional organizations, state, and local license fees;
• Allowances for education, professional meetings, travel, and automobile; and
• Entertainment, country/athletic club membership, and travel for spouse.

Not included:

• Voluntary employee salary deductions used as contributions to 401(k) and 403(b) plans; or
• Expense reimbursements.

Total advanced practice provider cost

The sum of the cost for full-time advanced practice providers and part-time advanced practice providers.

Advanced practice provider compensation cost [8410-8416, 8419, 8510-8516, 8519]¹¹

The number of FTE advanced practice providers in the practice. Advanced practice providers are specifically trained and licensed providers who can provide medical care and billable services. Examples of advanced practice providers include audiologist, certified registered nurse anesthetists (CRNAs), clinical nurse specialists (CNSs), clinical social worders (CSWs), dieticians/ nutritionists, midwives, nurse practitioners, occupational therapists, optometrist, physical therapists, physician assistants, psychologists and surgeon assistants. The total compensation paid to advanced practice providers who comprise the count of “Total advanced practice provider,” Cost column.

Included:

• Compensation for both employed and contracted advanced practice providers;
• Compensation for full-time and part-time advanced practice providers;
• Provider wages reported as direct compensation in
  • Box 5 on the W2.
  • Box 7 on the 1099.
  • Box 1 plus Box 4 minus Box 12 minus Box 13 from the provider’s K-1 form 1065.
  • Box 5 (Medicare wages and tips) from the provider’s W-2 plus Box 1 minus Box 11 minus Box 12 from the provider’s K-1 form 1120S.
• Bonus and/or incentive payments, research stipends, honoraria, distribution of profits; and
• Voluntary employee salary deductions used as contributions to 401(k), 403(b), or Section 125 plans.

Not included:

• Amounts included in “Advanced practice provider benefit cost,” Cost column;
• Expense reimbursements;
• Fringe benefits paid by the medical practice (such as retirement plan contributions, life and health insurance, automobile allowances); or
• Any employer contributions to a 401(k), 403(b), or Keogh Plan

Advanced practice provider benefit cost [8417-8418, 8420-8480, 8517-8518, 8520-8580]¹¹

Included:

• Employer’s share of FICA, payroll, and unemployment insurance taxes;
• Employer’s share of health, disability, life, and workers’ compensation insurance;
• Employer payments to defined benefit and contribution, 401(k), 403(b), and nonqualified retirement plans;
• Deferred compensation paid or expensed during the year;
• Dues and memberships in professional organizations, state, and local license fees;
• Allowances for education, professional meetings, travel, automobile; and
• Entertainment, country/athletic club membership, travel for spouse, etc.

Not included:

• Voluntary employee salary deductions used as contributions to 401(k) and 403(b) plans; or
• Expense reimbursements.

Staff Expenses:

Included:

• Salaries, bonuses, incentive payments, honoraria, and profit distributions;
• Voluntary employee salary deductions used as contributions to 401(k), 403(b), or Section 125 plans;
• Compensation paid to the total FTE count;
• Compensation for all support staff employed by all the legal entities working in support of the medical practice represented on this survey;
• The allocated support staff cost where the practice consists of multiple legal entities; and
• Compensation for both full-time and part-time employed support staff.

Not included:

• Expense reimbursements; or
• Any benefits or the cost of contracted support staff who do not work for any of the legal entities that comprise the medical practice.

Total Support Staff Cost

The sum of “Total support staff cost,” “Total employed support staff cost” and “Total contracted support staff cost.”

Total Employed Support Staff Cost [5100, 5200]¹¹

The "Total employed support staff benefit cost” benchmark represents the total benefits of all employed support staff reported in “Total employed support staff” FTE.

Included:

• Employer’s share of Federal Insurance Contributions Act (FICA), payroll and unemployment insurance taxes;
• Employer’s share of health, disability, life, and workers’ compensation insurance;
• Employer payments to defined benefit and contribution, 401(k), 403(b), and nonqualified retirement plans;
• Deferred compensation paid or expensed during the year;
• Dues and memberships in professional organizations, state, and local license fees;
• Allowances for education, professional meetings, travel, and automobile; and
• Entertainment, country/athletic club membership, travel for spouse.

Not included:

• Voluntary employee salary deductions used as contributions to 401(k) and 403(b) plans; or
• Expense reimbursements.

Total Contracted Support Staff Cost (Temporary) [5500-5570]¹¹

Contracted support staff represents all the staff hired on a contract basis, not employed by any of the legal entities that comprise the medical practice. The utilization of contracted support staff occurs when the medical practice (including all the associated legal entities that comprise the medical practice) decides not to hire support staff as employees to conduct the ongoing support staff activities. Instead, the practice contracts to have these full-time and/or ongoing activities conducted by contracted staff.

One example of this type of cost would be purchased services for billing and collections activities. When a practice decides to hire a billing company to conduct billing activities that the practice employees, it is often not possible to track the hours that the billing company devotes to the given practice. Such cost is reported as “Billing and collections purchased services.”

Included:

• Temporary staff working for temporary agencies; and
• Traveling nurses.

Not included:

• The cost of support staff employed directly by the practice or any of the legal entities comprising the medical practice. Such related costs are included in the “Total Employed Support Staff” section; or
• The cost for legal, accounting, management, and/or other consultants for services performed on a one time or sporadic basis. The costs for these types of consultants are reported as “Legal fees,” “Consulting fees,” and/or “Outside professional fees.”

Total Business Operations Support Staff Cost

The sum of the costs for “General administrative,” “Patient accounting,” “General accounting,” “Managed care administrative,” “Information technology” and “Housekeeping, maintenance, security.” Participants were required to provide this total even if they were unable to provide all the values requested below.

General Administrative Cost [5110-5111, 5117, 5210-5211, 5217]¹¹
Patient Accounting Cost [5112, 5212]¹¹
General Accounting Cost [5113, 5213]¹¹
Managed Care Administrative Cost [5114, 5214]¹¹
Information Technology Cost [5115, 5215]¹¹
Housekeeping, Maintenance, Security Cost [5116, 5216]¹¹
See Staffing section.

Total Front Office Support Staff Cost [5120, 5220]¹¹

A sum of the costs for “Medical receptionists,” “Medical secretaries, transcribers,” “Medical records” and “Other administrative support.” Participants were required to provide this total even if they were unable to provide all the values requested in previous questions.

Medical Receptionists Cost [5121, 5221]¹¹
Medical Secretaries, Transcribers Cost [5122, 5222]¹¹
Medical Records Cost [5123, 5223]¹¹
Other Administrative Support Cost [5124, 5224]¹¹
See Staffing section.

Total Clinical Support Staff Cost [5130, 5230]¹¹

A sum of the costs for “Registered nurses,” “Licensed practical nurses” and “Medical assistants, nurse’s aides.” Participants were required to provide this total even if they were unable to provide all the values requested in the previous questions.

Registered Nurses Cost [5131, 5231]¹¹
Licensed Practical Nurses Cost [5132, 5232]¹¹
Medical Assistances, Nurse’s Aides Cost [5133, 5134, 5233, 5234]¹¹
See Staffing section.

Total Ancillary Support Staff Cost [5140, 5240]¹¹

A sum of the costs for “Clinical laboratory,” “Radiology and imaging” and “Other medical support services.” Participants were required to provide this total even if they were unable to provide all the variables requested in previous questions.

Clinical Laboratory Cost [5142,5242]¹¹
Radiology and Imaging Cost [5141, 5241]¹¹
Other Medical Support Services Cost [5143-5160, 5243-5260¹¹
See Staffing section.