Pathologist Pay, Productivity and Negotiating with Payers

By Bob Croce

For The Executive War College

Unfortunately, it’s the perfect storm for pathologists and pathology practices. Pathology reimbursements are constantly being cut while labor costs are rising to all-time highs. The threats to the livelihoods of anatomic pathologists today are everywhere.

But at the Executive War College we have you covered with some important data, actionable info and best practices in our newly added session entitled, “What’s New in Pathologist Productivity and Compensation Plus Boosting Profitability through Effective Negotiations with Hospitals and Payers.”

This session, which is co-helmed by Bob Tessier, co-founder of the Panel of National Pathology Leaders (PNPL) think tank, and Al Sirmon, a lead consultant for Pathology Practice Advisors in Pawleys Island, SC., will cover all aspects of what you need to know to avoid the pitfalls of what has become a dicey pathology leadership challenge.

Bob Tessier, 
Co-founder of the Panel of National Pathology Leaders (PNPL) think tank

Al Sirmon,
Consultant for Pathology Practice Advisors

One topic of the session will be the correlation between productivity and pay.

“Some pathologists generate significant incomes, while others earn much less money for the same amount of work,” Tessier told The Dark Report in an article last August. “How can practices be more efficient? One way is for more pathologists to communicate and share the ‘secret sauce’ that works for them, which will benefit everyone.”

At last April’s Executive War College, Tessier detailed three steps that pathology groups can take to safeguard income and boost practice revenue:

  1. Determine fair market value for pathology services under Medicare Part A contracts with hospitals.
  2. With fee transparency, aim for “usual, customary, and reasonable” pathology charges.
  3. Seek extended contracts when feasible for Medicare Part B billing.

One of the challenges, of course, is that pathology practices are still operating under Medicare’s Reasonable Compensation Equivalent (RCE), published by the Centers for Medicare and Medicaid Services (CMS) way back in 2015. That report set as reasonable comp for pathologists just $125 per hour

Based on data from studies collected by Tessier and PNPL, the hourly pay rate for pathologists in 2023 was in the $160 to $274 range. A $240 rate would be in the 50th percentile, and $274 would be in the 75th percentile.

“Determining a pathologist’s worth can result in a huge range depending on where you start,” Tessier said. “Many hospital systems have been more than willing to accept hourly rates ranging between $240 and $274, depending on how the information about pathology compensation is presented.”

Much more to come during the session.

That’s it for this week. More dispatches to come. Hope to see you and your “krewe” in New Orleans.

(Bob Croce is Executive Publisher/General Manager of The Dark Intelligence Group, the company that brings you the Executive War College. Have a question or comment for Bob, you can reach him at

It’s all about not only dealmaking and networking; it’s about meeting new friends
A scene from our EWC 2023 welcome reception.

Click on the video below to hear more about the
Whole Genome Sequencing Workshop on Day 3 of Executive War College.

(Here are some recent additions to the EWC ’24 agenda)

Speaker: Heather Agnostinelli
Executive Director of Clinical Laboratory Operations,
Wisconsin Diagnostic Laboratories
Milwaukee, WI.

Speakers:Heather Agnostinelli
Vice President, Head of Specialty RCM and Clarisa Blattner, Senior Director of Revenue and
Payer Optimizations,
XIFIN, San Diego, CA.

Speaker:Laura Tafe, MD, Associate Professor of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH.

Speakers: Diana Richard, Senior Director, Pathology and Strategic Development and Stephanie Denham, Associated VP of RCM and Analytics, XIFIN, San Diego, CA.

Speaker: Paul Chenery
Head of Quality, Training & Strategic Improvement,
Nottingham University Hospitals NHS Trust,
Nottingham, England, UK

For ongoing updates, check out our AGENDA PAGE

Hear below what attendees had to say about EWC in 2023