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Serving Over 20,000 US Medical Transcriptionists

Slipping Backward - Line Rates and Cost of Living

Posted By: TechSupport on 2009-05-08
In Reply to:

This is for those of us who have been in the business awhile. 

 I stumbled across an online calculator that lets you input a dollar amount and a year in the past, and see what it would be today with cost of living increases.  (Link below).

You can use this with line rates and do it two ways - either as cents, which gives you a whole number result, or as dollars, which gives you the decimal portion as well.  In other words, if you made 8 CPL, you can either enter it as $0.08, or you can enter it as $8 and then move the decimal point over to the left two places in the result.  The multiplier is the same either way, so the dollar method with the extra decimal points is more precise.  Just remember to move the decimal point over.

I was making 10 cpl in 1990, so I gave it a spin and ran some different line rates through it using 1990 as the base year:

8 CPL = 12.96 in 2009

9 CPL = 14.6 in 2009

10 CPL = 16.2 in 2009

11 CPL = 17.8 in 2009

12 CPL = 19.4 in 2009

Is there any doubt that if the line rate had even kept up with the cost of living, people would not be feeling the way they do about this industry? 

Then I did something else and tried different input amounts to see what amount in 1990 would have equalled 9 CPL today - a typical line rate.   I had to back off to 5.56.  Someone earning 9 CPL today is making the equivalent of less than 6 CPL in 1990.

It's kinda fascinating playing with this thing (the way watching a train wreck is fascinating, I mean).  Here's a link you can paste into your browser, or you can follow the link at the bottom of the post.





LINK/URL: Online Cost of Living Calculator

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I think your last line is backward sm
To me, you sound like a realist in an idealist's world. And I totally agree with you. Both employers and MTs alike are wasting time mucking about with interviews and resumes, only to find out they are incompatible, when all could have been avoided if employers would just put what they have to offer out there. If they don't pay enough, I won't work for them, and investing my time in the interview process just makes me more prone to refuse an ultimately insufficient offer, not accept it.
You either need a job to fit your cost of living or a cost of living to fit your job. sm
While I agree that you cannot live in California on $35,000 a year, no one is forcing you to live in California. Suze Orman says either find a way to lower your expenses or find a way to earn more money. It's common sense :)

There was a post a few weeks ago about not everyone being cut out to be an MT. I agree.

The original poster needs to stop whining and either get a job that pays more or get a new career. She can make $15,000 on minimum wage at a mall or Walmart.

BTW, it was insulting of her to say that MOST woman don't need to work. How dare she? In this day and age, most adults need to work. This is not 1958, this is 2008. I am not a bra burner, but my husband and I both make similar money, clean the house, cook, raise our 3 children. I am just lucky to have a job where I can work from home. I hated commuting anywhere, hate traffic, no patience.

But that doesn't mean that I work less. I treat my job like a job. I work in my home office but I work all day. I do not do laundry, chat with friends, cook. I go to work each day by getting ready as if I were leaving for an office, pour my coffee, make sure I have everything I need and start. I take bathroom breaks and a lunch break and take the full hour that I would somewhere else. I work 8 full hours as I do not include my lunch hour, so my day is 8 to 5. When I am done for the day, I turn everything off, leave the room and close the door, as if I were in an outside office.

My husband has a salary of $71,000 and I make near the same as him each year. I do not work overtime except very rarely, an occasional Saturday here and there, just like if I were on salary in another profession.

I am not perfect, but I love my job and do it well. I also know that MT'ing is not for everyone, although it seems as if a lot of MT's who are not very good at their jobs have a sense of entitlement.
Variables in cost of living
Some states sound good, but then check out the taxes - real estate tax, personal property tax, sales tax, cost of heating/cooling, transportation, license plates, insurance, etc. A lot of it balances out in the end. Some states have outrageous license plate fees, (I paid over $600 for my car last year). I also get a personal property tax bill each year for everything including my dishes and silverware. State income tax is out of sight. Cost of heating in winter is unbelievable. I have to have 2 sets of tires for the car, 1 for winter, 1 for summer. I have to have 3 complete wardrobes for the weather changes.
does anyone know the cost of living in Bangalore? I need a job... lol nm
Cost of Living Increases

I work for a large MTSO and after four years have not received a cost of living increase. Is this standard operating procedure? Things cost more than they did four years ago. Do you think CEO is getting the same pay as four years ago? Any thoughts?

Cost of living is higher
In eastern bloc and Ireland and India. They're gonna want as much as we make. And if not now, then soon once they seal the deal. Plus our HIPAA laws still don't apply anywhere but here. There is still that.
It also depends on your cost of living.
I live on the California coast, which basically means I can't make a living at the national going rate. Fortunately, I also have one small local account that pays at a rate commensurate with the local cost of living, and because I have this, I can survive. Not sure I'd call it a good living, but I can get by.
They haven't forgotten about the cost of living.
They are having to compete with India and other countries and to do that they have to hold their line rate.  Their rent goes up, they have to pay support staff, etc.  I'm sure the majority of the companies are not struggling to meet their obligations every month, but the profits aren't what they used to be.   As MTs we were spoiled when we were making $60,000+ year when that was very good money, but now that $60,000 doesn't go very far, but you'll be hard pressed to find that kind of money in most positions in other job markets.  
But the MTSOs knew the cost of living would
contract with the hospital was even dry. They cut it too close by too much bottom-line bargaining, and didn't leave any wiggle room in order to be able to continue to pay the MTs that are the ones who actually produce what it is they're selling. No wonder we all play job-leapfrog all the time! The way they do business is too short-sighted to even be believed, sometimes. And the hospitals (most of which are WALLOWING in money) are taking total advantage of the average MTSO's lack of foresight, and most MTSO mangers' lack of even the slightest clue as to what medical transcription is, or how it's done. It's all too pathetic for words.
Heard no more raises or cost of living either.
to long time MT - the cost of living is about the same as the midwest - sm
you can have rent ranging anywhere from $500-900/month depending on where you live and what you want. It's not expensive like NY or DC or VA. The line rate is ABOVE - A-B-O-V-E 8.5/line and the docs are fairly easy with the exception of a few marblemouths, but I think every hospital has to have a few marblemouths, or it just wouldn't be right. If you are seriously thinking of it and would like to send us a resume, let us know your email and we will contact you!

We posted this because we wanted to know our options - rather than to have an outside service take the overflow.
Medware has been paying $14 for years, No cost of living increases there! nm
Cheating/verbal tests and cost per line.
I am sorry to hear this wonderful recruiter being called a cheater. I have been in this business for about 25 years, and I will take whatever help/advice I can get. Yes, I am in the transcription business to help people but I am also in it to help support my family. I'll take short cuts, macros, whatever it will take to increase my lines and if getting into a company that is willing to give a helping hand, a cue, a hint, whatever - I say thank you. In the end, if you do take pride in your work, the terminology will come to you in the actual report, and I bet the next time you hear those particular terms you have trouble with on the test, you will remember them. You will remember affect and effect. You will learn intra and inter because somebody's health may depend on it. Too bad for you.....
Can an MT make a decent living earning 7 cents per line

Just thought I would add my 2 cents worth.  It would be great to be paid 10-11-12-13 cents per line (as an employee not IC), but that is not a reality in this job market.  Yes, MTs will take jobs that pay 7 cents per line, but that MTSO is not necessarily underpaying or demeaning the MTs that work for them. 


Bottom line is that you have to do your homework because, yes, there are people who can make a living on 7 cents a line and will take those jobs.   It really depends on your skills and how dedicated you are to making your maximum possible lines per hour.  The MTSO that is offering only 7 cents a line but has easy dictators can actually pay you more per check if you type more lines per hour than an MTSO that is offering 10 cents a line but has horrible quality, ESL dictators, nasty QA, etc and you can barely type 100 lines an hour because of it. 


MY TIP:  When you interview, ask what the approximate minimum and maximum lines per hour that the other MTs that are doing EXACTLY the same accounts that you are going to be doing are achieving per hour/day/pay period.  If the recruiter/MTSO will not tell you that information, you probably donít want to work there anyway so just terminate the interview before wasting any more of your time.  The slowest MTs are probably new and the ones achieving 200-250-300 lines per hour have been there a long time and know the account(s) forwards and backwards.  If you plan to make that MTSO a long-term employer, you will have a pretty good idea of what you can potentially achieve if you stay there long enough.  Donít let them tell you the ďaverageĒ of all the MTs that work for the company or what their perfect employee Suzie Q types.   We all know every account is different, so Suzie Q who just started last week and is already doing 150 lines per hour may have easier accounts than the one you are going to be working on, so that is not very representative of what your account(s) is really going to be like.  Ask specifically about the accounts you will be assigned to and donít let them distract you.  Again, if they donít want to tell you, terminate the interview. 


According to the US Department of Labor, Bureau of Labor Statistics, Occupational Outlook Handbook, in 2004 !!!, the MEDIAN hourly earnings for a Medical Transcriptionist (probably  mostly hospital and office based) in May of 2004, was $13.64 an hour. 


Just for reference, it seems like most MTSOs have a 6000 lines per week minimum production standard which is about 150 line per hour (40 hour week) on average for full-time MTs.   


        If you are being paid 7 cents per line, you are making a minimum of (150 x 0.07) = $10.50 per hour.


        If you are being paid 8 cents per line, you are making a minimum of (150 x 0.08) = $12.00 per hour. 


        If you are being paid 9 cents per line, you are making a minimum of (150 x 0.09) = $13.50 per hour. 


        If you are being paid 10 cents per line, you are making a minimum of (150 x 0.10) = $15.00 per hour. 


If you are one of the highly trained experienced MT and type 200 lines per hour on average, you are even better off. 


        If you are being paid 7 cents per line, you are making a minimum of (200 x 0.07) = $14.00 per hour.


        If you are being paid 8 cents per line, you are making a minimum of (200 x 0.08) = $16.00 per hour. 


        If you are being paid 9 cents per line, you are making a minimum of (200 x 0.09) = $18.00 per hour. 


        If you are being paid 10 cents per line, you are making a minimum of (200 x 0.10) = $20.00 per hour. 



The median hourly earnings in 2004 was $13.64 per hour.  That was almost 4 years ago.  With a minimal 2% per year cost of living/inflation increase, by 2008 the median hourly earning should be about $14.76 per hour.       


2004 --------- $13.64

2005 x 2% = $13.91

2006 x 2% = $14.19

2007 x 2% = $14.47

2008 x 2% = $14.76


So, in my humble opinion, if you are an experienced MT with 5 or more years of experience, when you call that MTSO offering 7 cents per line the accounts you will be assigned to should be easy enough so that you can make an average of 210 lines per hour within a relatively short period of time.  If they say their experienced MTs are only doing 175 to 200 lines per hour on average, that MTSO is drastically underpaying their experienced MTs and it is time for you to move on.  If they say their MTs are averaging 250 to 300 lines per hour, then that MTSO may be worth looking into further, even if their starting wage is lower than what you originally thought you should be getting paid. 


I think if WE ALL start doing this, the MTSOs will start to figure out that we are not going to work for companies that underpay our skills and experience.  If enough experienced MTs hang up on these companies, eventually they will figure out that the recruiters/supervisors need to be more honest with us regarding their pay structure and the difficulty of their accounts. 


Some food for thought !! 


More information from the US Department of Labor, Bureau of Labor Statistics, Occupational Outlook Handbook: 

Medical transcriptionists had median hourly earnings of $13.64 in May 2004. The middle 50 percent earned between $11.50 and $16.32. The lowest 10 percent earned less than $9.67, and the highest 10 percent earned more than $19.11. Median hourly earnings in the industries employing the largest numbers of medical transcriptionists in May 2004 were:

General medical and surgical hospitals


Offices of physicians


Business support services




If you want more information, check out the US Department of Labor, Bureau of Labor Statistics web page for Medical Transcriptionist. 






line rates
When I started I was told line rates are based on years of experience and what account you work on.  When you are hired they give you a pay matrix so it is easy to see exactly what you are making.  They also pay a shift differential after 6PM and have an incentive plan that is paid at 12,000 per pay (2 weeks). 
Line rates
Why do all these companies keep dropping their line rates?  The cost of living sure isn't falling. 
Line rates
Because they can get away with it. As an experienced MT, at this point I will go work doing something else before I will take less, but I am frustrated that there are so many out there who are willing to sell themselves short. I also will happily learn voice recognition or do QA but not at my expense. I keep wondering what the fallout in this profession will be.
Line Rates


Could anyone tell me what to expect for a decent line rate... I never see any ads for more than about 8-9c per line?  Thanks. Lou

TRS ....line rates...etc.

Dear TRS-er --

I worked for TRS for a few months back in 2000 and had a very good experience with them, had to leave for unrelated reasons.  I cannot remember what they paid me per line, but I now have over 20 years of MT experience.  I am looking for 10 cents a line.  Do you think they will pay me that figure, or more?  And what if I take the CMT test (have not taken it yet), how much more will I get?  

Also, do they ever run out of work for more than say a few hours?  

Thanks for your answers...hope to chat more with you very soon, as I want to leave my present company very soon.  




line rates

We have different line rates for different accounts, ranging from 9 to 10 cents per line without spaces but include headers and footers and 8 cents per line with spaces.  Our MTs who transcribe on both platforms say their pay is the same day in and day out..


Line rates
experience and what account/schedule you work, that is what their recruiter told me.  Plus they have 2 levels of incentive. I have them in the top 2 choices and will make my decision this weekend, but they seem to have work and offer a nice overall package.  I would rather work for a smaller national that one of the big ones.
There are companies that do base pay on experience and they are well over 0.85 or 0.825.  You just need to find them. 
line rates
Best I can figure, 8 for 55 is equal to 8.8 at 65.
I have not seen line rates go up! Seems to me
VR line rates

I've been doing QA for a long time, but like everything else, the pay has gone down, down, down.  Does anyone know of companies paying better than 4 cpl for VR.  Or companies paying 10 cpl for transcribing?  Getting desperate.  Thanks for any info!

PS:  Please remember to vote for the candidate you believe will get us out of this outsourcing mess that has lowered our wages.

line rates
Higher than where I came from, 8.1 cpl for ERs that are gravy to type.  I get 9-10K lines per week. They have started new accounts this year and we also just got a nice MT Week gift card in the mail.  I think they are a great company and they keep me in work. 
Line rates?
How is their starting line rate? Do they ever give raises?
pay per line rates
The company that bid on the contract and won it sets the rate. If they bid it at 7 cpl and 11 cpl, you are not going to make more than 3/4 and 7/8 cpl. There are a lot of costs involved with hiring MTs. Its not cheap. Getting MTs set up in payroll, getting IDs, shipping equipment, etc costs money. Unfortunately, many MTs accept a position and then turn around and quit. I have seen and experienced it first hand. MTSOs and larger companies cannot afford to pay high rates. They often lose money, especially early on with a new contract.

just saying. take it for what it is worth.

per line rates
What are people getting paid per line that work for MTSO's?
line rates
The line rate for the oncology account varies depending on your oncology experience.  I have found the platform to be very user friendly so I think it depends on your ability to adapt to new things.  Be prepared to be very busy, to learn templates and have good quality.  A good account requiring concentration and a sound knowledge of oncology.
Say No To Low Line Rates!
I did it twice. Just told them I would not even consider working for what they offered. If everybody said that to every low offer maybe the line rates would come up. Then again, could recruiters be getting bonuses for finding people deseprate enough to work for 6 cents a line? Sorry state of affairs, is it not?
Sorry, but line rates have dipped in the SM

past 5 years.  If you can negotiate with any of these companies and get 11 cpl, more power to you.  I have found it difficult to get them to give 9 or 10 cpl myself.

There's also the issue of plenty of work.  Usually, if you are in the 8 cpl-range, there is no problem landing with a company who can keep you busy all the time (but you'll be on a number of different accounts-I can guarantee that).  BUT....there are also plenty of companies talked about on these boards that run out of work frequently, their accounts are overflow (feast or famine), etc.


Why do you accept line rates like this? nm
Voice Rec. line rates?
I'm considering taking a job doing Voice Recognition editing, but what is the average line rate I can expect for this type of work?  I see some ads for editing, but none of them include the pay rate.  I have 5+ years of experience as an MT.  Thanks!
There are better line rates out there, just have to look and not accept less sm
I currently work for 2 different companies.

My FT employee-status job I make 9.5 cpl, I started at 8.5 cpl and after 6 years worked my way up to 9.5 cpl. I also get an incentive if I type a certain amount over the minimum.

My PT IC job I started at 9 cpl (lower line rate but better system to work on - so lines come easy) Been there 3 months.

There are jobs out there. I have 9.5 years experience and don't know why people who have been in the business for 25 years or more are getting low offers. Perhaps your education isn't what you thought it was. If you have a solid background of A&P, pharmacology, college composition, and a strong work ethic, you should make more than 6-7 cpl. Honestly, you can't get a good education taking a home-based MT course, you need to go to a real college with real teachers and do an internship before you graduate. A good education can almost double your money after 5 years in the industry compared to those who didn't get the training or classes they needed to understand the stuff they type.
why do you all say they have higher line rates? sm
I applied there thinking they would offer me something competetive and I was offered 8 cpl for 6 years' experience. Not on your life.

I turned them down flat.
Higher line rates
When I was with MQ, I was making 9.75 cents a line, but I accepted a position with another company for 8.5 cents a line. The lines are easier to come by with this company, so it equaled out anyway. By the way, have 20 years experience. These companies only pay so much. What do you get per line?
Higher line rates
Yes, worked for the company MQ bought up for about 3 years before that. I left because I was not making money at MQ anymore, was working harder for less money with the cesspool and all, was making about 500.00 less a month. I am back where I was with MQ before all the changes financially, and really like the company I am with. I read on here that MQ was offering 12 cpl (I think) for people to come back. I got a few phone calls, but never called them back.
VR/ASR/MT pay rates & line counts
I've found that editing ASR reports takes me as long as typing them straight would have. Yet getting 60% of the pay rate for those lines makes that a LOSING proposition! I'm wondering if others are just letting the many ASR errors slide through uncorrected as a way of keeping their line rates up? I can't bring myself to do that, but the pay cut is killing my self-esteem.

Is there ANYBODY out here who will admit to being able to make the same amount of money per hour on ASR as on MT?
Axolotl line rates
Could you share a ballpark cpl for someone with 20+ years experience? TIA
MDI-FL is advertising top line rates. Anyone know what amount that is? nm
If they keep offering those pathetic line rates
RE: Editing at extremely low line rates
If you get a discount on the coffee, I'm in....LOL
Editing at extremely low line rates.
What are the standard rates for Quality Assurance Editing these days? Well, that depends on what you are editing. If you are editing TRAINED Voice Recognition files expect to make less per line, maybe a couple of cents per line. For UNTRAINED Voice Recognition files, you should be earning at least 3 cpl or better. Editing relatively clean reports that require very little change should earn you up to about 4 cpl. Editing transcribed reports by new grad MTs or offshore MTs should earn you 5 to 6 cpl. I really don't think I'm far off base here, but I am certain that if you take a job editing transcribed reports done by offshore MTs, you should not accept anything less than 5 cpl, otherwise you are doing yourself a disservice even if you are trying to break into Editing. Feel free to respond.
Some things to consider that factor into line rates. sm
There are two sides to this. The larger companies like MQ, Spheris, Transcend, Keystrokes, et AL have a lot more accounts and more volume so they make their money on volume and can pay more. They also have more overhead than smaller MTSOs and need payroll people, recruiters, benefits people, etc.

But here is what no one considers: If I pay someone 0.09 per line, I have to pay taxes and unemployment on them. My portion is 15% between SS and unemployment. Benefits such as PTO and the portion I pay for insurance and 401K (there is a fee to the employer to have someone run it at the company that you have your 401K with), etc cost me approximately 22% more. So actually, 9cpl + 37% = 12.3cpl. Add the cost of doing payroll, bank fees, liability insurance, etc. and there is not a whole lot left over. Most hospitals will not pay more than 13cpl, some 14cpl. My break-even is 13.2 cpl. This is normal; I talk to many MTSOs at MTIA meetings and on my own. The big ones above are the only ones that make a lot of money, but their companies produce a lot of lines every month.

Do I make good money? Yes, but I put in a lot of time getting accounts and keeping them happy, doing the juggling act to keep my employees busy on good accounts. Payroll takes time, recruiting takes time, sales take time PLUS a lot of accounts take a lot of day-to-day work.

I am not complaining about being an MTSO, I just want you to know that there are two sides to everything and the industry changes prevent us from paying more than 7 to 9 cpl. Factor in offshore driving our costs down and those companies that undercut everyone, and small MTSOs may go the way of 8-Track Tapes.

I see the industry going to just 10 companies or so and hopefully they can stay in business too with speech recognition, offshore and everything else that comes along.
Focus - what are their average line rates??
You hear good, bad, so-so and ugly about them.  One thing you never see is what exactly are they paying.  I hate to waste my time talking, applying, or testing with anyone who doesn't disclose their pay rates.  I have extensive EXText experience, including the EXSpeech Turbo (which is awesome I might add).  I know that VR doesn't always pay as well as it should, but if it's a productive platform and I don't have to type 50-blue-million ESL guys, I don't expect to make 8 cpl.  However, just exactly what can you expect.  If I have to edit or transcribe quality work that doesn't require you to go back and fix every other report, or if I'm not sending tons of reports to the QA person to figure out my blanks, I expect to be able to make good money for my experience.  Is anyone willing to share what their pay rates are?  If I can't average 22-25 an hour....not worth looking at. 
MQ and Spheris line rates for SR/trans?
Can anyone tell me what editing/trans rates are for these companies? Are there any production incentives?
Spheris line rates & incentives
Some employees at Spheris are now being told that production and QA incentives will be eliminated. The line rate is variable, but in general, the very least you will accept. This used to be a wonderful company. Very little concern now for either employees, quality of work, or serving best interests of clients. Many are leaving.
Need current info on ETransPlus i.e. work load, line rate (ballpark), cost of benefits, SM
and overall treatment of their MTs.  I found archived opinions but all old.  Is anyone there now that can comment?  Thanks!!
People discuss line rates, yes, but pay, I still say is not professional
everyone is banned for discussion line rates being offered