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Instruction 590-1: Title 38 Physician and Dentist Pay (PDP)

Issuance Date: March 28, 2013

Material Transmitted:

Department of Health and Human Services (HHS) Instruction 590-1, Title 38 Physician and Dentist Pay (PDP), dated March 28, 2013.

Material Superseded:

HHS Instruction 590-1, Title 38 Physician and Dentist Pay (PDP), dated November 28, 2011.

Background:

This Instruction has been revised to delegate the same maximum level of physician and dentist pay authority to all Operating Division (OPDIV) directors in the Department.

This issuance is effective immediately.  Implementation under this issuance must be carried out in accordance with applicable laws, regulations, bargaining agreements, and Department policy.

 

/signed/
Denise L. Carter
Deputy Assistant Secretary for Human Resources


This Instruction implements HHS regulations and procedures for payment of Physician and Dentist Pay (PDP).

  1. Coverage:  This Instruction covers civilian physicians and dentists (full-time and part-time) at GS-15 and below who:
    1. Provide direct patient care services, or services incident to patient care; and
    2. Have been designated for coverage by appropriate authority.
    3. As used in this document, references to physicians include both physicians and dentists.
  2. Categorical Exclusions:  This instruction does not apply to physicians who are:
    1. Currently serving in the Public Health Service (PHS) Commissioned Corps;
    2. Serving in an internship or residency training program;
    3. Reemployed annuitants;
    4. In the Senior Executive Service (SES), Executive Schedule (ES), Senior
    5. Level/Scientific (SL/ST), Senior Biomedical Research Service (SBRS), Executive Level (EL), or other senior-level systems;
    6. Receiving Physicians Comparability Allowance (PCA) under 5 U.S. Code 5948;
  3. Employed or paid under a Title 42 authority; or

    1. Serving on intermittent work schedules.
  4. Former Members of the Uniformed Services:  Former members of the Uniformed Services, i.e., the Army, Navy, Air Force, Marines, Coast Guard, National Oceanic and Atmospheric Administration and the PHS Commissioned Corps, may receive Physician and Dentist Pay.  
  1. 38 U.S. Code, Chapter 74 (Law - Veterans’ Health Administration - Personnel)
  2. 5 U.S. Code 5371 (Law - Health Care Positions)
  3. Public Law 93-638, Section 105(e) (h) (Indian Self-Determination and Education Assistance Act)
  4. Public Law 99-221, Section 3(a) (Cherokee Leasing Act)
  5. U.S. Office of Personnel Management Title 38 Delegation Agreement, dated April 2006.
  1. Aggregate Pay: The sum of all payments made to a physician or dentist in a calendar year, exclusive of lump sum annual leave, reimbursement of travel, back pay, and severance pay, which may not exceed the rate of pay for the President of the United States (currently set at $400,000).
  2. Annual Pay: The sum of the General Schedule (GS) base pay rate and market pay. Annual pay is basic pay for purposes of computing civil service retirement benefits, lump sum annual leave payments, life insurance, thrift savings plan, work injury compensation claims, severance pay, recruitment, relocation and retention incentives, continuation of pay, and advances in pay.
  3. Compensation Panel: A group of physicians and/or dentists responsible for the evaluation of physicians or dentists and for making recommendations to the approving official for annual pay.
  4. Management Official: A person who has supervisory authority over staff or program management responsibility.
  5. Market Pay: A component of annual pay intended to reflect the recruitment and retention needs for the specialty or assignment of a particular HHS physician or dentist.
  6. Tier: A level within the annual pay range for an assignment or specialty.
  7. Total Compensation: The sum of all payments made to a physician and dentist including base pay, market pay, recruitment, relocation and retention incentives, performance awards, or other cash awards.
  8. Total Pay: The sum of all payments made to a physician and dentist. Total pay includes base pay, market pay, recruitment, relocation, and retention incentives and excludes cash awards. In Alaska, Hawaii, and Puerto Rico, where the Office of Personnel Management (OPM) has approved a non-foreign cost-of-living allowance (COLA) under 5 U.S.C. 5941, total pay also includes the COLA.
  1. Discretionary Application: PDP is available for use to recruit and retain highly qualified physicians. Payment of PDP is optional in each OPDIV. (Throughout this Instruction, references to OPDIV Heads imply that authorities may be redelegated.)
  2. Within budgetary constraints, HHS policy is to compensate physicians at levels reasonably comparable with those paid to other federal sector physicians in the same local area.
  3. Establishment of PDP Amounts: PDP amounts for physicians will be established on an individual basis according to GS Base Pay and Market Pay (See Section 70, Market Pay, and Exhibit A, which describes approval authorities).
  4. Relationship to Basic Pay: PDP (annual pay) is basic pay for all benefits including retirement.
  5. Relationship to Premium Pay Under Title 5: Physicians who receive PDP may not:
    1. Be paid overtime for work in excess of 8 hours per day, 40 hours per week, or 80 hours per pay period;
    2. Earn compensatory time off in lieu of overtime pay or compensatory time off for travel; or
    3. Receive any other form of premium pay under Chapter 55 of Title 5, U.S. Code, e.g., Sunday, holiday, night pays.
    4. Physicians and Dentists receiving PDP will be covered by the HHS Performance Management Appraisal Program.
  6. Other Discretionary Pay Under Title 5: Physicians who receive PDP may receive other forms of discretionary pay under Title 5, such as awards, recruitment, relocation, and retention incentives (5 U.S. Code 5753 and 5754). However, they are not eligible to receive a Physicians’ Comparability Allowance (PCA) under 5 U.S. Code 5948.
  7. The sum of base pay and any discretionary pay which is paid to a physician or dentist under Title 5 authority, (e.g., cash awards, performance awards, recruitment, retention, and relocation incentives) is limited on an annual basis to the rate of pay for Executive Level I (EX-I).
  8. Aggregate Compensation Limits: Total compensation of physicians receiving PDP under Title 38 authority, basic pay, and other supplemental pay under Title 5 cannot exceed the amount of annual pay received by the President of the United States as specified in Section 102 of Title 3.
  9. Effective Dates: PDP will usually be effective at the beginning of the pay period immediately following approval by the approving official or on a later date specified on HHS Form 691 (Exhibit B). PDP may not be approved retroactively; however, depending on the circumstances, an administrative error may be corrected retroactively. (PDP will be paid on a bi-weekly basis.)
  10. Outside Work: Because of the work obligation associated with PDP, physicians who wish to perform outside work must submit a prior written request under established agency procedures. Any activity interfering or conflicting with the employee’s federal work obligation will be disapproved.
  11. Part-Time Service: Part-time physicians who have a tour of duty of at least 20 hours per pay period may be offered PDP.
  12. Relationship to Leave Under Title 5: Physicians who receive PDP continue to be covered by the leave provisions of Chapter 63 of Title 5.
  1. Office of the Assistant Secretary for Administration (ASA):
    1. The ASA/Office of Human Resources (OHR) is responsible for obtaining the concurrence of the Interagency Committee for Health Care Occupations on the HHS PDP Plan.
    2. The ASA/OHR is responsible for preparing the annual report of use of PDP as required by OPM.
  2. OPDIV Heads:
    1. OPDIV heads are responsible for ensuring that merit system principles and the requirements of the Title 38 statute, the OPM and HHS delegation agreement, and this Instruction are followed in their use of PDP.
    2. OPDIV heads are responsible for reviewing requests for approval of outside work activities from physicians and dentists for possible conflict of interest with federal work obligations.
    3. OPDIV heads are responsible for maintaining auditable program records, and for participating in evaluation of this authority by OPM, HHS, or other administrative authority.
  3. Approving Officials (OPDIV Head designee):

Approving officials are responsible for reviewing and certifying that PDP requests comply with the provisions of law, the OPM and HHS delegation agreement, and this Instruction.

  1. New or Renewal Actions: Management officials proposing PDP must complete HHS Form 691 (Exhibit B) and provide:
    1. A copy of the candidate's/employee's qualifications statement or curriculum vitae;
    2. The position description; and
    3. Written market pay justification.
  2. Information listed in A above should be forwarded by the proposing official to the compensation panel for review and recommendation to the approving official for a decision. The decision of the approving official is final.
  3. Once approved, cases will be forwarded with supporting documentation to the servicing HR Center for:
    1. Processing of a Notification of Personnel Action (SF-50); and
    2. Maintenance of records in the employee's Official Personnel Folder (OPF).

NOTE: Maintain supporting documentation on the left side of the OPF.

  1. Each physician and dentist covered by this part is eligible for market pay. Market pay is intended to reflect the recruitment and retention needs for the specialty or assignment of a particular physician or dentist at an HHS facility.
  2. At least once every two years, the VA Secretary prescribes nationwide minimum and maximum amounts of annual pay (base pay plus market pay) that will be paid under this paragraph. These amounts are published in the Federal Register for not less than 60 days prior to the effective date. The VA Secretary may prescribe different ranges for different specialties or assignments. In determining pay ranges, at least two or more national surveys of pay for physicians and dentists are consulted. National surveys consulted include data that describes overall physician and dentist income by specialization or assignment and benefits in broad geographic scope.
    1. When the VA increases the nationwide minimum and/or maximum amounts of annual pay under this paragraph, physicians and dentists are not automatically entitled to a corresponding increase in their individual annual pay rates. Only physicians and dentists whose existing rate of annual pay falls below the newly prescribed nationwide minimum for their designated pay range will automatically receive an increase in market pay to make their annual pay rate equivalent to the new nationwide minimum. Compensation Panels review the market pay rates for individual physicians and dentists on a periodic basis.
    2. In the event that the nationwide minimum and maximum amounts of annual pay are reduced under this paragraph, physicians and dentists already on HHS rolls will not experience a reduction in market pay.
  3. There may be up to four tiers of annual pay for each specialty or assignment for which a separate range of pay has been approved. Each tier reflects different professional responsibilities, professional achievements, or administrative duties. See Exhibit C.
  4. The amount of market pay and appropriate tier for a particular physician or dentist is recommended to the approving official.
  5. The determination of the amount of market pay of a particular physician or dentist shall take into consideration:
    1. The level of experience of the physician or dentist in the specialty or assignment;
    2. The need for the specialty or assignment of the physician or dentist at the facility;
    3. The appropriate health care labor market for the specialty or assignment of the physician or dentist;
    4. The board certifications, if any, of the physician or dentist;
    5. The accomplishments of the physician or dentist in the specialty or assignment; and
    6. Consideration of unique circumstances, qualifications or credentials, if any, and the comparison of these circumstances to the equivalent compensation level of non-HHS physicians or dentists in the local health care labor market.
  6. Each OPDIV will establish one Compensation Panel that will be responsible for PDP Program oversight and guidance. These Panels will ensure that there is consistency and appropriateness of pay determinations within the OPDIV and periodically review physician and dentist pay under the PDP Program.
  7. All Compensation Panel recommendations are taken into consideration by the appropriate approving official. The approving official determines the amount of market pay to be paid a physician or dentist after consideration of the range and tier recommended by the panel. The approving official’s decision is final.
  1. GENERAL
    1. Except as provided in paragraphs A.2 through A.4, and B., below, the annual pay for a physician or dentist may not exceed the maximum amount in the nationwide pay range prescribed by the Secretary of the VA for a specialty or assignment.
    2. It is expected that the maximum amount in the nationwide pay range will meet most pay and staffing needs. However, the OPDIV Head may grant an exception to the maximum on an individual, specialty or assignment, and/or facility-specific basis if such action is necessary to recruit or retain well-qualified physicians and dentists.
    3. Exceptions to the maximum amount in the nationwide pay range will only be considered if failure to approve the exception would significantly impair an organization’s ability to recruit and retain well-qualified physicians and dentists.
    4. Exceptions to the maximum amount of a nationwide pay range are not required for physicians and dentists who will exceed the pay range due to a GS step increase or a statutory general increase in pay.
  2. CRITERIA FOR APPROVAL: Each organization submitting a request for an exception to the maximum in the pay range for an individual, specialty or assignment, and/or facility-specific basis must demonstrate that a higher maximum is necessary to maintain adequate staffing. Factors to consider include:
    1. Exceptions to the Maximum Annual Pay Ranges
      1. Higher Maximum Rates
        1. There is substantial evidence or anecdotal information that the maximum rates in the community are higher than the Department’s maximum rate for the specialty or assignment. However, higher rates in the community may not be the sole basis for making a request for an exception to the maximum of the market pay range; and
        2. Employees are quitting for pay and the potential exists for an adverse impact on the organization;
      2. Alternative Job Offers: There is evidence that applicants and employees are being offered higher rates of pay for the same assignment or specialty in the labor market. Historical evidence indicates that the quality of or a lack of candidates is unacceptable for the assignment or specialty. Documentation of specific recruitment efforts must be provided to support this factor; and
      3. Other Criteria: The organization may submit any evidence of pay-related staffing problems which seriously hamper or have the potential to seriously hamper its ability to recruit and retain physicians and dentists in the specialty or assignment.
    2. Individual Exception to the Maximum of the Annual Pay Range
      1. The individual should have outstanding qualifications in a medical or dental specialty or possess a unique combination of education and experience that meets a special need of the organization that may be project specific or critical to the HHS mission.
      2. A discussion of what factors distinguish the individual when compared with other physicians or dentists with like length of service, specialty, and assignment; or a discussion of the rare combination of education and experience which the individual has and how it meets a special need of the organization or the mission of HHS.
  3. REQUESTING EXCEPTIONS: Requests for exceptions to the maximum of the nationwide pay range will be sent to the OPDIV head with a recommendation from the Compensation Panel.  Requests shall include the following:
    1. The individual or specialty or assignment for which the exception is requested;
    2. The amount of maximum pay requested;
    3. The reasons for the request, including documentation specific to the criteria in paragraph B; and
    4. Any other pertinent information.

Exhibit A. Summary of Title 38 Physician and Dentist Pay Approval Authority

Title 38 Physician and Dentist Pay Approval Authority

AUTHORITY HELD BY DELEGATED TO
1. Establish Title 38 Physician and Dentist Pay regulations and procedures. ASA NA
2. Approve requests for PDP when proposed total compensation exceeds $250,000. ASA NA
3. Approve requests for PDP when proposed total compensation exceeds Executive Level I (EX-I). ASA OPDIV Heads
4. Approve PDP for individuals reporting directly to the OPDIV head ASA OPDIV Heads
5. Approve exceptions to the maximum of the annual pay range. ASA OPDIV Heads
OPDIV COVERAGE – Food and Drug Administration (FDA)
TIER 1 Non-Supervisory Medical Officer and Dentist
TIER 2 1st Level Supervisor (Branch Chief) and Team Leader
TIER 3 Medical Officer/Dentist (Division and Deputy Division Director) with independent resources (personnel, budget and space).
TIER 4 Medical Officer/Dentist (Office, Deputy Office Director and Center Director) that has responsibility for a complex group or organization that has agency-wide or nation-wide impact.

Tier Descriptions for Indian Health Service

OPDIV COVERAGE – Indian Health Service (IHS)
TIER 1 Staff Physician or Dentist
TIER 2 First level supervisor, Clinical Department Head, Clinical Director at outpatient or free standing clinic.
TIER 3 2nd level supervisor, Clinical Director of Hospital/Medical Center
TIER 4 National Program Responsibilities (Normally a Headquarters Function)

Tier Descriptions for Centers for Medicare and Medicaid Services

OPDIV COVERAGE – Centers for Medicare and Medicaid Services (CMS)  
TIER 1 Staff Physician or Dentist
TIER 2 Supervisor, Program Manager, Division Director, Team Director
TIER 3 2nd level Supervisor, managing an organizational unit that is subdivided into distinct functional groups (i.e., Group Director)
TIER 4 Director or Deputy over a complex group of organizations that have National Program Responsibilities (i.e., Center/Office Director/Deputy)

Tier Descriptions for National Institutes of Health

OPDIV COVERAGE - National Institutes of Health (NIH)
TIER 1 Non-supervisory physician/dentist providing patient care services in support of biomedical research.
TIER 2 Supervisory or Program Manager physician/dentist functions as a fully credentialed, fully trained clinician with patient care responsibility.
TIER 3 Physician/Dentist with independent resources (personnel, budget and space) who provides patient-related activities.  Publishes and presents original peer-reviewed scientific research at national meetings.
TIER 4 Physician or Dentist with responsibility for a complex group or organization that has agency-wide or nation-wide impact.  Growing body of published and presented original peer-reviewed scientific research at national and international meetings. Recognized by receipt of national and international awards.

Tier Descriptions for Centers for Disease Control and Prevention

OPDIV COVERAGE - Centers for Disease Control (CDC)
TIER 1 Staff Physician or Dentist, Non-Supervisory Research Scientist 
TIER 2 Supervisor, Program Manager, Branch Chief, Team Chief/Leader, peer-reviewed Senior Research Scientist having significant impact on the field
TIER 3 Second-Level Supervisor who manages an organizational unit that is subdivided into distinct functional groups (i.e., Division Director)
TIER 4 Director or Deputy over a complex group of organizations that have National Program Responsibilities (i.e., Center or Institute Director/Deputy)

Approved Pay Ranges For Physicians And Dentists EFFECTIVE October 11, 2009

PAY TABLE 1 AND CLINICAL SPECIALTIES

TIER LEVEL MINIMUM MAXIMUM
TIER 1 $96,539 $195,000
TIER 2 110,000 210,000
TIER 3 120,000 235,000
TIER 4 130,000 245,000

Covered Clinical Specialties – Allergy and Immunology, Endocrinology, Family Practice, Geriatrics, Hospitalist, Infectious Diseases, Internal Medicine, Neurology, Preventive Medicine, Primary Care, Psychiatry, Rheumatology, General Practice—Dentistry, Endodontics, Periodontics, Prosthodontics, and  Assignments that do not require a specific specialty

PAY TABLE 2 AND CLINICAL SPECIALTIES

TIER LEVEL MINIMUM MAXIMUM
TIER 1 $96,539 $220,000
TIER 2 115,000 230,000
TIER 3 130,000 240,000
TIER 4 140,000 250,000

Covered Clinical Specialties – Critical Care (board certified), Emergency Medicine, Gynecology, Hematology - Oncology, Nephrology, Pathology, Physiatry, and Pulmonary

PAY TABLE 3 AND CLINICAL SPECIALTIES

TIER LEVEL MINIMUM MAXIMUM
TIER 1 $96,539 $265,000
TIER 2 120,000 275,000
TIER 3 135,000 285,000
TIER 4 145,000 295,000

Covered Clinical Specialties – Cardiology (Non-invasive), Dermatology, Gastroenterology, Nuclear Medicine, Ophthalmology, Oral Surgery, and Otolaryngology

PAY TABLE 4 AND CLINICAL SPECIALTIES

TIER LEVEL MINIMUM MAXIMUM
TIER 1 $ 96,539 $295,000
TIER 2 125,000 305,000
TIER 3 140,000 325,000
TIER 4 150,000 335,000

Covered Clinical Specialties – Anesthesiology, General Surgery, Plastic Surgery, Radiology, Therapeutic Radiology, Urology, and Vascular Surgery

PAY TABLE 5 - CHIEF OF STAFF

TIER LEVEL MINIMUM MAXIMUM
TIER 1 $150,000 $275,000
TIER 2 145,000 255,000
TIER 3 140,000 235,000

PAY TABLE 6 AND EXECUTIVE ASSIGNMENTS

TIER LEVEL MINIMUM MAXIMUM
TIER 1 $145,000 $265,000
TIER 2 145,000 245,000
TIER 3 130,000 235,000

Covered Executive Assignments – Principal Deputy, Deputy and Assistant Under Secretary for Health, Chief Officer and Chief Consultant, Network Director, Medical Center Director and Chief Medical Officer, National Program Manager, and other Central Office Physician/Dentist

PAY TABLE 7 AND CLINICAL SPECIALTIES

TIER LEVEL MINIMUM MAXIMUM
TIER 1 $96,539 $375,000
TIER 2 140,000 385,000

Covered Clinical Specialties – Cardio-Thoracic Surgery, Interventional Cardiology, Interventional Radiology, Neurosurgery, and Orthopedic Surgery

 
Content created by Assistant Secretary for Administration (ASA)
Content last reviewed on September 25, 2016