Proforma for Adding PET and PET/CT

The decision to add a dedicated PET or PET/CT scanner to your imaging center involves many factors including market demographics, local competition, reimbursement estimates, and many cost assumptions. A proforma is a useful tool to help simulate your business model with varying assumptions.

Some initial assumptions should be made in you proforma model:

Available Payment Options

• Five year FMV (Fair Market Value) lease, no downpayment, 10 year financing on facility/room, and 7 year financing on hot lab and other capital equipment
• Five year Capital Lease, $300,000 downpayment on the scanner with 5 year financing, 10 year financing on facility, and 7 year on hotlab and other capital equipment
• Cash purchase for the scanner, facility/room, hot lab and other capital equipment

Service Costs

• Assume somewhere between 7% and 10% of the purchase price per year starting in year 2 (after 12 month warranty period).

Some revenue inputs to consider in a proforma include:

Operations

• Number of days per year PET procedures will be performed
• Average number of daily procedures projected each year (including free cases)
• Current or projected payer mix for PET
• Are professional fees captured by your facility or an independent physician or physician group (Y/N)

Payment

• Medicare reimbursement rate for PET procedures in your geography – based on APC or IDTF, this will or will not include FDG
• Professional fee reimbursement depending on geographic location
• Projected gross charge for private payers
• Professional charge for private payers
• Percentage of private payer charges collected
• Projected net revenue per procedure for out of pocket (cash) payers – consider bad debt
• Projected net revenue per procedure for out of pocket (cash) for professional fee

Some cost inputs to consider in a proforma include:

Start Up Costs

• Projected cost of PET or PET/CT scanner
• Tax exempt status - If not exempt, your local sales tax rate
• Lease information
• Facility construction costs
• Hot lab, office or other capital equipment
• Start up licensing or permit fees
• Incidental start up costs

Employees

• Projected annual FTEs and average salary
• Employee benefits

Annual Costs

• Space (rental)
• Marketing costs
• Standard maintenance agreement
• Telephone costs
• Utility costs
• Insurance
• Licensing and permits
• Miscellaneous

Variables

• Average acquisition costs per dose of FDG
• Cost of delivery per dose of FDG
• Film cost per procedure
• Average disposable and supply costs per procedure
• Miscellaneous per procedure

Tax/Inflation Factors

• Annual inflation rate
• Facility income tax rate