Guidance on Setting A Reasonable Rate for After-Hours Practice Call Compensation

The BFMV Cost of Physician Staffing Services is a publication released by BFMV in the spring of each year. The study analyzes government contracts with physician staffing companies representing 88 physician specialties across the U.S. to determine rates paid to fill physician vacancies at government facilities.

After-Hours Coverage vs ED On-Call

A helpful insight from the BFMV Cost of Physician Staffing Services (CPSS) shows how organizations pay physicians for providing after-hours coverage of a practice or clinic. When valuing this type of call coverage, it’s important to distinguish it from coverage being purchased by a hospital for covering unassigned patients presenting to the emergency department (ED) or providing emergency consults to other medical staff members’ patients. Market data for those services reflect a high level of burden and greater possibility of needing to respond to the facility in person, whereas after-hours coverage of a practice or clinic generally has a low burden rate, with physicians more likely responding to established patients or clinical staff telephonically or electronically instead of in person.

Guidance for After-Hours Coverage Rates

As described in the 2024 CPSS report, many physician staffing companies reviewed in the study provide after-hours call coverage services for the practice or clinics they staff. In most situations, after-hours coverage services are only available in connection with the purchase of temporary on-site services. Companies in the study typically price on-call services in one of two ways. Some companies charge a set hourly rate for every hour a temporary physician is on-call, while others charge one rate for the entire call coverage period. The on-call rate generally covers phone availability, phone consultations, and the ability to return to work within 30 minutes (when necessary). If a temporary physician is asked to return to work while on-call, staffing companies in the study will generally require the standard on-site hourly payment, with a set minimum, while the physician provides on-site services.

Perhaps the most significant finding revealed in the CPSS report is that the sum charged for after-hours coverage is often equal to one hour at the regular on-site hourly rate. For example, a staffing company might charge $288 per hour for on-site staffing of a clinic and then provide after-hours coverage for $288. Assuming the after-hours coverage period lasts 16 hours, that translates to $18 per hour. In our view, using this approach – paying for one hour at the regular staffing rate for after-hours coverage – is a reasonable approach to establishing a rate for low-burden after-hours coverage of a practice or clinic.

The CPSS Report is available here for immediate download ($150 purchase). For more information, contact us.