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[00:00:00] Hello everyone. Welcome to The Testing Psychologist podcast, the podcast where we talk all about the business and practice of psychological and neuropsychological assessment. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

This podcast is brought to you by PAR.

PAR offers three co-normed tests to assess memory in youth: the ChAMP, the MEMRY, and the MVP. Used together, they provide comprehensive information about memory and performance validity. Learn more at parinc.com\memry.

Many of y’all know that I have been using TherapyNotes as our practice EHR for over 10 years now. I’ve looked at others and I keep coming back to TherapyNotes because they do it all. If you’re interested in an EHR for your practice, you can get two free months of TherapyNotes by going to thetestingpsychologist.com/therapynotes and entering the code “testing”.

[00:01:00] Okay, everybody. We are back and I am glad to be talking with you as always.

Today, I am tackling a question that comes up a lot in my individual and group consulting sessions, which often provide content here for the podcast. I am talking about how much to pay psychometrists and how to approach payment for psychometrists.

This is a thing that is important. For many of us, hiring a psychometrist is the first baby step into growing our practices or offloading some of the less desirable aspects of our jobs. So figuring out what to pay them is surprisingly challenging for a number of reasons. So I will dig into how I approach paying psychometrists and of course, present a little bit of data as well to reinforce the discussion.

Before we get to that, if you are looking for some support in your practice especially on the business side, I would love to help you out.

Now, it’s always hard to [00:02:00] gauge. I record these in advance, so I am guessing that I may have 1 or 2 spots available for individual consulting starting at the beginning of April. So if you would like to talk about working together, you can go to thetestingpsychologist.com/consulting and schedule a pre-consulting call. We will talk, figure out if it’s a good fit, and then figure out where to go from there. And if not, I’ll try to hook you up with any other resources that do make sense.

All right, let’s jump to this discussion of paying psychometrists.

All right, folks, here we go. 

I’ve talked before about psychometrists on the podcast. Of course, we’ve talked about [00:03:00] benefits of them, where to find them, a little bit about how to train them or onboard them, and touched maybe here or there on payment. But today I’m going to dedicate this entire episode just to thinking about how to pay your psychometrist.

Before I do that, I will jump quickly to some of the benefits of a psychometrist or why you might want to consider one.

The first one is offloading some of your work. You can offload all of the testing or some of the testing. You can have someone help with the scoring. This is generally what we tend to have a psychometrist do.

A psychometrist is someone who administers the tests and scores the tests for us. Typically, they will also transfer those scores into your report in some form or fashion. I know many practitioners out there also have psychometrists writing at least the behavioral observations and sometimes other elements of the report as well.

[00:04:00] So a psychometrist can take on some of that work that you may not want to do at this point whether you need some help, or you want to free up some time, or you are bored of doing all the testing, which is a valid feeling. That’s one reason we might bring on a psychometrist.

A second is that we get to have a second set of eyes on the client. A well-trained psychometrist can function as a good check and balance, checks and balances. Either way, a good psychometrist can function as a check and balance system for your own biases.

If you’re not aware of some of the biases that we face as clinicians, I would highly encourage you to go back and listen to the episode with Dr. Stephanie Nelson called We’re All Wrong Sometimes, I’ll link that in the show notes, where she talks about all the biases that come up in our work.

Having a psychometrist is a nice [00:05:00] second data point or person to get eyes on the client to help us see things through a different lens and simply add more dimension to the clinical judgment, which I think is a good thing.

Another reason you might consider a psychometrist is for better or for worse, it is in alignment with more of a medical model. And for some folks, clients that is, that presents a little more validity or authority or gives you a little more credibility.

I use the analogy in our practice, because we use psychometrists frequently, that a psychometrist is like a radiology tech. They make sure that the MRI machine is fired up, working properly, and calibrated appropriately. They prepare the client for the experience. They help the client feel comfortable. They make sure that all the correct procedures are followed. Essentially, they’re guaranteeing that we obtain accurate [00:06:00] data. And then we, as the radiologist in this metaphor, read the data and make the clinical conclusions.

This description seems to resonate with clients pretty well. If you don’t want to go into that much detail, you can always keep it pretty general and just say, yes, this is a bit like a medical model where you’ll have a physician and a physician’s assistant who helps out in the process. Some folks appreciate that. Again, it might land a little more credibility.

The last reason I’m going to give for taking on a psychometrist, and these are not exhausted by any means but a few things to consider, is training in some cases or otherwise providing opportunities for others to develop their skills. If this is something that you care about and you want to invest in, having a psychometrist is a nice way to mentor others, to provide some [00:07:00] supervision if you are bringing on a grad student, for example, or simply to develop someone in the field of testing and who knows where that individual might go down the road. They may go on to get a PhD. They may stay as psychometrists, but it’s still a nice way to provide some of that oversight and give back, if you will provide supervision, and mentorship, and a lot of folks enjoy that.

These are a few reasons why you might consider a psychometrist. Let’s dig into the practice or the process.

Again, very briefly, people always ask, where do you find psychometrists? I’ve done other episodes on that. I’ll say that you generally look in the same places as for psychologists, by which I mean, grad school programs, retired or otherwise flexible school psychologists, [00:08:00] tutors, or executive functioning coaches.

I would also add bachelor’s psychology programs, the Board of Certified Psychometrists directory, even though it was a little sparse, state Psych association websites or listservs, neuropsych listservs, and even, of course, topic-specific Facebook groups like The Testing Psychologist Community or the school psych Facebook groups. These are all great places to look for psychometrists.

Let’s take a break to hear from a featured partner.

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They make billing, scheduling, note-taking, and telehealth all incredibly easy. They also offer custom forms that you can send through the portal. For all the prescribers out [00:09:00] there, TherapyNotes is proudly offering e-prescribe as well. Maybe the most important thing for me is that they have live telephone support seven days a week so you can talk to a real person in a timely manner. If you’re trying to switch from another EHR, the transition is incredibly easy. They’ll import your demographic data free of charge so you can get going right away.

So if you’re curious or you want to switch or you need a new EHR, try TherapyNotes for two months, absolutely free. You can go to thetestingpsychologist.com/therapynotes and enter the code “testing”. Again, totally free, with no strings attached. Check it out and see why everyone is switching to TherapyNotes.

when you’re assessing memory and children in adolescents, remember these three assessment tools from PAR: the ChAMP, the MEMRY, and the MVP. These measures were developed specifically for use with children, adolescents, and young adults. Used together, the three instruments, [00:10:00] which are co-normed, provide you with comprehensive information about memory and performance validity. Learn more at parinc.com\memry.

All right, let’s get back to the podcast.

All that preamble aside, let’s get to the actual payment terms.

Here’s the TL;DR. If you want to stop listening right now, you could very likely be safe with paying your psychometrist 25% of collected revenue for the part of testing that they conduct. There you go. If you want to dip out, do something different, that’s your number, 25%. That will keep you pretty safe. If you’d like to get into the nuances a little bit, then stick with me here.

Publicly available information on the internet is as expected all over the map. Salaries for psychometrists range from about $40,000 a year, that’s for full-time, [00:11:00] up to over $200,000. The only way that that is possible is if your psychometrist was making $100 an hour working 40 hours a week. That seems extremely rare and implausible, but it could happen. Never say never.

That said, the majority of psychometrists are making between $20 an hour and $50 an hour, depending on a variety of factors. I will say the average in the Denver metro area here in Colorado is about $31 an hour, give or take just for reference, but there are several ways to approach this calculation depending on your situation.

So I think of it as the intersection between the experience of the person that you’re hiring, the fee structure in your practice, by which I mean insurance versus private pay and hourly versus flat rate, and the standard of living in your area. Let’s dig into that. What do I mean?

Experience-wise, [00:12:00] a quick note on experience, there is a board of certified psychometrists. I will say though, that the vast majority of psychometrists are not certified. So that is not something you have to look for if you are trying to hire a psychometrist. Generally speaking, anyone with a bachelor’s can be a psychometrist. More experience is always helpful though, as you might expect.

If you want to dive deep into psychometrists, I would encourage you to look at the episode with Dr. Christine Ghilain where she talks through the book that she wrote: A Neuropsychologist’s Guide to Training Psychometrists. That was a fantastic episode. I will link that in the show notes as well.

What do you consider it with experience?

We tend to bring on grad students as psychometrists. These are advanced PhD students or PsyD students. They’re in the 3rd or 4th year of their program. They’ve already had testing experience, [00:13:00] a fair amount of testing experience, and we know that they have a demonstrated interest in assessment.

So, is your person going to be a grad student? Will they be more like a post-master’s individual? Would they be more like an intern or even a postdoc? I wouldn’t advise having interns and postdocs function solely as psychometrists because it’s a disservice to their training to only get that experience, but I’ve seen it done. Are they just a bachelor’s level person, which is fine? Are they a retired professional with years of experience in the field? These are all things to consider. That is directly related to how much guidance or supervision they will require, which factors into how much you pay them.

If they’re not a student or otherwise informal training, you’re thinking how many years of experience do they have doing the job of a [00:14:00] psychometrist? You may be surprised to find that there are a number of folks out there who are very experienced psychometrists. Of course, they tend to command a higher rate of compensation.

I think this is relatively intuitive, but the less experience someone has, the less they will likely make as a psychometrist. If you bring on grad students, you do also need to factor in not just the training to get them up to speed, but the supervision that you will hopefully be providing throughout the year to increase their administration skills.

For our psychometrists who are grad students, we make sure that they have weekly group supervision and we do case consultations with them. I’ll call it a brief case consultation each day that they test for us. So we’re talking through the behavioral [00:15:00] observations and the data to help them start to develop some of those conceptualization skills as well.

Getting back to the payment and experience for grad students, again, requiring the most supervision, I would ballpark their compensation at closer to 15% to 20% of reimbursement rather than that 25% number that I cited earlier.

All right. Experience is important. The fee structure in your practice is also important.

Again, I said insurance versus private pay, and if you’re private pay flat rate versus hourly. Unfortunately, it goes to assume that typically insurance-based practices can afford less for a psychometrist. The 25% number should still make sense even in an insurance-based practice, but I will caution you, if you’re in an insurance [00:16:00] based practice, I would not go much higher than that. Now, if you’re private pay, you can afford a bit more. I think that goes without saying. In most cases, there are all these exceptions, but most of the time, if you’re private pay, you can afford a bit more. So you may choose to jump up to even 28% or 30%.

Now, if you’re private pay, I think the flat rate per eval versus hourly makes sense. I’m always a fan of flat rates in private pay if you can do it, but a few things have to be in place for it to make sense.

If you know that your evals take 4 hours of testing and 2 hours of scoring and writing, give or take a little bit, not much, like maybe 15 to 30 minutes, give or take, then I think you can get away with a flat rate and pay the psychometrist per evaluation. So you essentially [00:17:00] take whatever hourly rate you might be paying them, multiply it by 6 in this example, and that’s their flat rate. They get $150 per case.

This helps limit the risk of a psychometrist taking up tons of time for those who are more deliberate or slow workers. However, as with the general discussion of flat rate versus hourly, it does not work well in practices that have inconsistent billing. So you have to have a lot of predictability and consistency to make this work. The risk, of course, is that you end up overpaying the psychometrist for time that they didn’t spend.

So if you’re private pay and you have predictability in your billing and your testing process, I think you can get away with a flat rate per eval. If not, especially if you’re insurance-based, I would not consider a flat rate. I would [00:18:00] consider an hourly rate because there’s too much variability and risk, especially with insurance that you will not get reimbursed. And you don’t want to get caught paying for hours that insurance doesn’t pay for.

So the takeaway from this, as far as fee structure, is if you’re private pay and you’re pretty predictable, you can consider doing a per eval payment for the psychometrist. If you are insurance-based or you do not have a lot of predictability in your private pay practice, then I would go with an hourly rate just to give you a little bit more control and able ability to measure and keep track of a psychometrist’s work.

The last component is geography or standard of living. What do I mean by this? What I mean is on the extreme ends of the financial spectrum or standard of living spectrum, there is a chance you’re going to end up either paying your [00:19:00] psychometrist too little or too much if you go by that ballpark calculation of 25% of collections.

Let’s do another example. If you’re in an extremely high-income area where you’re charging, say $300+ an hour, it does not make sense to pay a psychometrist $75 or more in most cases. That’s going to exceed the average or even above average compensation in the vast majority of places. It outpaces the reasonable salary for this position.

If you want to do that, of course, you can. The math is going to work out. You’re again, keeping it around that 25% of the collections number. The math will work out. It’s going to put that psychometrist way above most of their peers in [00:20:00] terms of compensation.

On the flip side, if you’re only getting paid $80 or less per hour, you’re going to run the risk of paying the psychometrist too little. Remember that range I gave earlier that psychometrists tend to make between $20 and $50 an hour? I think that accounts for 98% of psychometrists.

And so, if you dip below $20 an hour, that’s starting to look pretty low and it’s even within shouting distance of minimum wage in a lot of places. So you might run the risk of paying your psychometrist too little. Again, as with the other, you can always do it. You can do it and run the risk of maybe losing the psychometrist. You can also flex up and pay maybe 30% of collections if you have room in your budget to do it. Again, that’s a little bit of a risk.

In either case, you can adjust up or down to match the [00:21:00] market rate and match the needs to retain the psychometrist but be very careful. I think you have to be a little bit more deliberate if you’re in one of those areas that lie on one of the ends of the financial spectrum.

Okay, folks, quick and dirty approach to how to pay psychometrists. I wonder where that comes from. Quick and dirty. Why is it dirty? I don’t understand. If somebody knows that, please let me know. Send me an email: jeremy@thetestingpsychologist.com.

A quick and easy way, we’ll go with that, to figure out how to pay a psychometrist. Again, easy takeaway. If you remember nothing else, just say 25%t of collections. And if you want to go into a little more detail, then you can mess with your numbers, look at your budget, look at the market you’re in, and adjust a little bit up or down.

[00:22:00] There are always going to be outliers and unique situations, but I hope that this has given you some sense of how to approach psychometrist compensation.

All right, y’all. Thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and your life. Any resources that we mentioned during the episode will be listed in the show notes. So make sure to check those out. If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes, Spotify, or wherever you listen to your podcast.

If you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist mastermind groups. I have mastermind groups at every stage of practice development, beginner, intermediate, and advanced. We have homework. We have accountability. We have support. We have resources. These groups are amazing. We do a lot of [00:23:00] work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call and we will chat and figure out if a group could be a good fit for you. Thanks so much.

The information contained in this podcast and on The Testing Psychologist website is intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional, psychological, psychiatric, or medical advice, diagnosis, or treatment.

Please note that no doctor-patient relationship is formed here, and [00:24:00] similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and listeners of this podcast. If you need the qualified advice of any mental health practitioner or medical provider, please seek one in your area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.

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