Your PMI fee schedule hasn't been reviewed in years and you're being paid below market rate

Fee schedules are not reviewed unless a problem is identified Consultants have no easy access to market rate comparators Insurers do not volunteer information about rate disparities

• Fee schedules have not been reviewed since initial onboarding
• Consultants do not have access to what peers are being paid for the same procedures
• Insurers apply rates selectively and do not disclose the range
• The consultant assumes any increase must be individually negotiated with no precedent
• The opportunity cost of inaction is invisible until a comparison is made

A 20% rate gap on £120,000 of annual PMI revenue is £24,000 of income left on the table every year. Over three years with no review, that is over £70,000.

• Cumulative underpayment over multiple years represents significant lost income
• Revenue cannot grow proportionately with cost inflation on a static fee base
• The consultant's effective hourly rate declines year on year
• Resource available for practice investment is constrained by underearning
• The gap widens as peer consultants negotiate and the stagnant contract falls further behind

What it looks like in practice

• A consultant who discovers they are 20% below the market rate for a core procedure on £120,000 of annual PMI revenue has left £24,000 on the table in the previous year alone
• A structured fee review supported by published rate benchmarks (for example PHIN where available) and a specialist advisor typically supports a meaningful rate increase in the first negotiation cycle
• Consultants who have not renegotiated in three or more years are statistically the most likely to achieve a significant rate increase in the first attempt, because the gap from market rate is widest