Actually, if the hospital is using the 2023 rates for wRVUs then a 99232 is 1.59 now and a 99233 is no 2.4. So assuming you're billing 99232 and 99233 as 50/50, you're now averaging 2 wRVUs per f/up instead of 1.7 under the 2022 rates. Doesn't seem like much, but at 10 f/ups per day working 22 days a month, that's an extra 200 wRVUs per quarter.
@samac , this would be something important to clarify for any inpatient billing you're going to be doing. Outpatient rates didn't really change, but inpatient f/ups are significantly more.
If it's 12-15 patients per day, that's probably ~10 f/ups and 2-3 new patients on average. So ~30 wRVUs per day. At ~22 days per month, that's 1,980 per quarter for 1,039 wRVUs in production bonus. At $79.5 per wRVU (if that's the actual rate and it's uncapped, then wow) that's an extra $86.5k per quarter or $330k/yr. Meaning $585k/yr total for salary and production bonus, which would be great. As you said, the fact that they're holding the extra 15% says this isn't the case though.
Sounds like you'd be splitting the inpatient unit. So probably more like 5-8 patients which means probably 4-5 f/ups +1-2 new per day. If 2023 rates, that probably averages about 15 wRVUs per day on the inpatient side or ~1,000 wRVU per quarter. If that's the number, then you hit your minimum and it's about $4-5k in production bonus quarterly with that alone. Then depends on what your outpatient clinic looks like. Let's say after no-shows you see 15 hours of patients per week, so 3 hours a day. Say you do 30 minute f/ups and 60 minute new which averages ~4 wRVUs per hour, that's an additional 800 wRVU per quarter that should all go towards the production bonus, so an extra $65k per quarter or ~$250k per year making your total income roughly $500k. Which would actually be very fair for this position.
You may not need to make a counter offer, but you need to hammer down some more solid numbers for this position. The $79.46/wRVU production bonus with no caps seems too good to be true, unless they're not expecting you to hit those numbers, in which case you should be asking why. Ask if your production is based on what you bill or what is collected, if it's the latter then demand it be switched to wRVUs billed or walk.
You also need to find out about how call is handled. Sounds like if it's just you and one other person, terrible call may be the catch. How often are you on weekend call? Every other weekend? Who covers overnights? What about patient messages on the outpatient side? I'd also recommend talking to the other psychiatrist working there and asking how many RVUs they make and if they're willing to share their income so you have an idea of what the position will actually look like.
I'd be interested to hear the thoughts of some of the more experienced people here.