Many Agencies Pay A Lot For In-House ICD 10 Coding. Meanwhile, Your Profit Margins Continue To Shrink. Make The Change Today. (Part 2)

April 16, 2022

In part 1 of our ICD coding series, we looked at an overview as to why smaller agencies can’t afford to do in-house coding. In part 2, we will look at the dollars and cents of coding in-house. If you currently have employees in this role, have you broken down the true cost to your agency and determined productivity standards?

Cost And Productivity Of In-House ICD 10 Coding:

When we think of productivity in our agencies, we normally talk about clinical employees. Many agencies to not track the number of charts individual coders complete or monitor accuracy in a meaningful way. An RN who is certified in Oasis D and ICD 10 coding should be able to code 12 charts per day or 60 charts per week. If your in-house coders aren’t completing 240 charts a month, you may need to ask why. Our numbers come from a nationwide outsourcing company with many nurse coders on staff. It should also make you ask why you have multiple coders if your admission numbers don’t justify it. It is not uncommon for us to see several in-house coders for agencies with 200 admissions or less. So, let’s do math on cost.

The national average according to Zip Recruiter for an RN who is Oasis D and ICD 10 coding certified is $67,571 base salary. If you consider the average overhead rate of 34% of salary ($22,974), then your overall cost per coder is $90,545. Now, this is just the average. So, we realize there are agencies paying less and agencies paying a whole lot more. The same nationwide agency providing productivity numbers stated it is not uncommon for their coders to be paid $78,000 for base salary. Based upon this number, an in-house coder would cost a total of $104,520 ($78,000 base salary + $26,520 overhead). Now, let’s break these costs down for your agency numbers.

Based on the national average of $90,545 ($67,571 base salary + $22,974 overhead):

1. An agency averaging 100 admission per month is actually paying $905.45 per chart for a coder of this caliber.

2. 150 admissions per month cost the agency $603.63 per chart for the coder.

3. 200 admissions per month cost the agency $452.72 per chart for the coder.

4. 250 admissions per month cost the agency $362.18 per chart for the coder.

5. 300 admissions per month cost the agency $301.81 per chart for the coder.  

If we look at these same numbers based on the $78,000 base pay with overhead to total $104,520, the numbers look like this:

1. 100 admissions= $1045.20 per chart for coding

2. 150 admissions= $696.80 per chart for coding

3. 200 admissions= $522.60 per chart for coding

4. 250 admissions= $418.08 per chart for coding

5. 300 admissions= $348.40 per chart for coding


Kenyon Homecare Consulting charges $65 for ICD coding and Oasis analysis/ review. Based upon those numbers and the level of expertise and certification, you need to do the math for your agency. If your RN coder is doing 240 admissions per month and is certified and accurate, your in-house coding may work well for you in a cost analysis. In our experience, agencies doing 240 admissions per month with in-house coding normally have several coders on staff. So, the costs for your coding department go up drastically. You may be paying the national average of $90,545 for three or four coders to handle your admissions. Suddenly, you are paying between $271,635- $362,180 per year just to keep your ICD 10 coding in- house.  Those same admissions done by Kenyon Homecare Consulting's RN Coding Specialists will save you anywhere from $76,635-$167,180 per year to complete 250 admissions per month.

Let Us Be Your Choice For ICD 10 Coding:

At Kenyon Homecare Consulting , our ICD 10 coding department works with agencies to help them improve documentation and get the dollars they deserve to service patients. All our coding staff are Oasis and ICD 10 certified RNs who know our industry and the requirements in documentation. Call us today at 206-721-5091 or contact us online to see how we can help you save money and still receive excellent coding accuracy and efficiency.

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