A concierge medical practice charges patients a membership fee, often once a year, on top of normal billing. The fee buys close access to a personal physician. Harvard Medical School reporting puts concierge fees in a wide band. The range runs from thousands to tens of thousands of dollars a year. The model trades panel size for time and steadier income.
This article explains the model. It covers the fee, the service list, and the federal billing lines. Figures and rules trace to sources listed at the end. They include Harvard Medical School, the HHS Office of Inspector General, and the AAFP. The growth figures come from late 2025 reporting on a Health Affairs study. We covered a connected angle in Medical Billing and Coding Practice Software: What to Compare.
How a concierge medical practice charges
The structure is simple. Patients pay a periodic fee under a contract. The practice commits to a defined set of services. Harvard reporting puts concierge fees in the thousands to tens of thousands per year. A cousin model, direct primary care, charges less. Those fees often run several hundred to a few thousand dollars a year.
The AAFP describes direct primary care as periodic payments for a defined set of services. The payments replace third-party billing for primary care. The practice gains a steady income line. The patient gains access a standard schedule rarely allows. The fee also shifts the billing office. Fewer payer claims per patient means fewer payer rules per visit. Readers following this should also see Medical Practice Marketing: What Works Within the Rules.
What the fee buys the patient
The package centers on access and time. Most offers anchor on same-day visits and longer appointments. A direct line to a physician rounds them out. The AAFP notes extended visits, real-time messaging, and sometimes home visits. Panels stay small by design. That small panel is what makes the service level possible. Time is the real product. Everything else is packaging.
Insurance does not vanish. Patients keep coverage for specialty care, hospitals, and major events. The fee covers the services named in the contract. Contracts should state that split in plain words. A plain contract prevents billing surprises later. Renewal terms deserve the same care.
The Medicare line not to cross
Federal rules draw a hard line for Medicare patients. OIG education materials state it twice. The rule is short. A doctor cannot ask Medicare patients to pay again for services Medicare already covers. Fees for non-covered services stay allowed. An access fee that merely unlocks covered services counts as double billing.
The safe design keeps two lists. Covered visits bill Medicare as usual. The fee applies only to items outside coverage. The contract should name those items one by one. The OIG page gives a worked example of the wrong shape. A yearly fee bundled an annual physical with faster appointments. Those items sit under Medicare coverage. That fee fits the double billing pattern.
Growth and market numbers
The segment grows fast. Harvard reporting on a Health Affairs study found these practices grew 83 percent from 2018 to 2023. Clinician counts rose 78 percent in the same span. Corporate ownership rose too. Growth that fast invites scrutiny, which makes the billing rules above worth a reread. A practice weighing the shift also weighs panel math. Fees shrink the panel by design. The math is plain. Half the panel at twice the fee can hold revenue flat.
Conclusion: what to settle before converting
Conversion work happens before the first fee posts. Set the service list, the fee, and the contract. Split covered from non-covered services in writing. Brief Medicare patients on what stays inside normal billing. Update notices and enrollment forms.
The sourced checklist item comes from OIG guidance. A fee may cover non-covered services only. It may never charge a second time for care Medicare already pays for. Every concierge medical practice agreement should pass that test, line by line.
