DPC Monthly Fees: What's Included and What's Not

Direct primary care (DPC) promises transparent, flat-fee healthcare. But "flat fee" doesn't mean everything is free. Understanding exactly what your DPC monthly fee covers — and what it doesn't — prevents surprises and helps you plan your total healthcare spending accurately.

This guide breaks down DPC pricing, inclusions, exclusions, and the 2026 regulatory framework that shapes what practices can and cannot include.

2026 DPC Pricing Overview

According to the 2026 DPC Pricing Index by Hint Health (2026), the national average DPC membership costs $92/month, with a median of $80/month. Most patients pay between $50 and $150 per month for unlimited primary care access. The Direct Primary Care Coalition mapper (2024) tracks roughly 2,200 DPC practices across all 50 states — about 4x the count five years ago.

Pricing by age group:

Pricing by region:

One-time enrollment fees of $50-$200 are standard across the industry, covering initial health assessment and medical records transfer.

What's Included in Your DPC Monthly Fee

Unlimited Office Visits

The cornerstone of DPC. Your monthly fee covers as many office visits as you need. No copays, no visit limits, no surprise bills.

Most DPC doctors schedule 30-45 minute appointments — roughly double the 16-minute average reported in the 2022 NAMCS by the CDC for traditional primary care.

Common visit types included:

• Wellness checkups and annual physicals
• Acute illness visits (cold, flu, infections)
• Chronic disease management (diabetes, hypertension, thyroid)
• Medication management and adjustments
• Minor injury assessment
• Mental health screening and basic counseling
• Pre-operative clearance exams

Basic Lab Work

Most DPC practices include common laboratory tests in the monthly fee.

Typically included:

• Complete Blood Count (CBC)
• Comprehensive Metabolic Panel (CMP)
• Lipid panel (cholesterol)
• Hemoglobin A1C (diabetes screening)
• Thyroid panel (TSH, T3, T4)
• Urinalysis
• Basic STD screening
• Strep and flu rapid tests

Varies by practice (sometimes included, sometimes at cost):

• Vitamin D levels
• Iron studies
• Liver function panels
• Hormone panels
• PSA screening

DPC practices that don't include labs in the monthly fee typically offer them at wholesale pricing. The Annals of Family Medicine 2020 cost analysis found DPC patients paid 50-80% less for basic lab work than commercial insurance equivalents. A comprehensive metabolic panel that costs $200+ through a hospital might be $15-$25 through your DPC practice's lab pricing.

Telehealth and Virtual Visits

Most DPC practices (85%+) include telehealth as part of the membership:

• Video visits for non-emergency concerns
• Phone consultations
• Secure messaging with your physician
• After-hours telehealth for urgent questions

Virtual visits for a DPC member work exactly like in-office visits — included in your monthly fee with no additional charge.

Minor Procedures

Many DPC practices perform minor procedures in-office, included in the membership:

• Wound care (suturing, wound cleaning)
• Skin tag removal
• Mole checks and biopsies
• Joint injections (cortisone, hyaluronic acid)
• Ear wax removal
• Ingrown toenail treatment
• Cyst drainage
• Wart removal
• Skin lesion freezing (cryotherapy)
• Splinting for minor fractures

The availability of in-office procedures varies by practice. Some include all procedures. Others include basic ones and charge at-cost for more complex procedures.

Care Coordination

Your DPC physician manages referrals and coordinates with specialists:

• Specialist referral recommendations
• Medical records transfer
• Communication with specialist physicians
• Post-hospital follow-up coordination
• Second opinion facilitation

While the specialist visit itself isn't covered by DPC (that's what your insurance handles), the coordination work is part of your monthly fee.

Preventive Care

DPC practices emphasize prevention, typically including:

• Annual wellness exams
• Age-appropriate health screenings aligned with USPSTF recommendations (current grade A and B services, 2024)
• Immunization administration (vaccine cost may be separate)
• Health risk assessments
• Lifestyle counseling (nutrition, exercise, sleep)
• Smoking cessation support

What's NOT Included in Your DPC Monthly Fee

Understanding exclusions is equally important. Under the Primary Care Enhancement Act provisions in the SECURE 2.0 Act (Section 320, 2026), DPC arrangements must exclude certain services to maintain HSA eligibility.

Specialist Visits

DPC covers primary care only. If you need to see a cardiologist, dermatologist, orthopedist, or any other specialist, that's covered by your separate health insurance — not your DPC fee.

Hospital Care

Emergency room visits, hospital admissions, surgical procedures, and inpatient care are not covered by DPC. This is why you need health insurance alongside your DPC membership.

Advanced Imaging

MRIs, CT scans, PET scans, ultrasounds, and X-rays are not included in DPC. Some practices negotiate discounted imaging rates for their members, but the cost is separate from the monthly fee.

Prescription Medications

The PCEA specifically excludes prescription drugs from DPC arrangements (except vaccines). Many DPC practices still help patients in three ways:

• Help patients find the lowest prescription prices through tools like GoodRx or Mark Cuban's Cost Plus Drugs (2024 pricing)
• Provide dispensing of common generic medications at wholesale cost
• Connect patients with prescription discount programs

Some DPC practices maintain an in-office dispensary of common generic medications at near-wholesale prices (often $4-$10 per medication per month). This is technically separate from the DPC membership fee.

Procedures Requiring General Anesthesia

Any procedure requiring general anesthesia is excluded from DPC under the PCEA. This includes surgeries, colonoscopies under anesthesia, and other complex procedures that require an operating room setting.

Complex Lab Work

Lab services "not typically administered in an ambulatory primary care setting" are excluded. This means specialized genetic testing, advanced cancer markers, and complex endocrine panels are not covered by your DPC fee.

Mental Health Services

Your DPC physician can screen for mental health conditions and provide basic counseling. Dedicated mental health care from a psychiatrist, psychologist, or therapist is not included.

Some DPC practices partner with mental health providers to offer discounted rates for their members. If you are in crisis, the 988 Suicide and Crisis Lifeline is available 24/7.

The DPC + Insurance Equation

DPC replaces the primary care component of healthcare, but you still need insurance for everything else. The most common pairing combines DPC with a high-deductible health plan.

DPC + HDHP (High Deductible Health Plan)

This combination often costs less than a comprehensive PPO plan while providing better primary care access. The Kaiser Family Foundation Employer Health Benefits Survey (2024) put the average family PPO premium at $25,572/year — far above the typical DPC+HDHP combination.

And since DPC fees are now HSA-eligible, the tax savings make this even more attractive. For a deeper dive on pairing DPC with insurance, see our guide on concierge medicine and insurance.

How DPC Practices Set Their Fees

Understanding how practices price their memberships helps you evaluate whether you're getting fair value.

Revenue Model

A DPC physician with 600 patients at $100/month generates $720,000 annually. After practice expenses (rent, staff, supplies, technology), physician compensation typically ranges from $200,000-$350,000.

That is competitive with traditional primary care according to the MGMA 2024 Provider Compensation Report, but with significantly lower patient volume and less administrative burden.

Panel Size Impact

The number of patients a DPC physician accepts directly impacts both pricing and access:

Smaller panels mean higher fees but better access. Larger panels mean lower fees but potentially longer wait times. Most DPC physicians target 400-600 patients as the sweet spot.

What to Watch For

Red flags in DPC pricing:

• Excessive enrollment fees ($500+ should be questioned)
• Monthly fees above $150 without clear justification (unless in a premium market)
• Fees for basic services that should be included (routine office visits, basic labs)
• Required insurance billing — true DPC does not bill insurance for primary care services
• Long contracts — month-to-month or quarterly billing is standard; multi-year commitments are unusual

Frequently Asked Questions

What happens if I need a lab test that's not included?

Your DPC physician orders the test, and you pay the discounted rate. Many DPC practices negotiate wholesale lab pricing, meaning you'll typically pay 50-80% less than hospital or commercial lab prices. A comprehensive metabolic panel might cost $15-$25 through your DPC practice vs. $200+ billed through insurance at a hospital lab.

Can I use my HSA to pay for DPC membership in 2026?

Yes. The Primary Care Enhancement Act made DPC memberships HSA-eligible as of January 1, 2026. Your monthly DPC fee can be paid from your HSA or used to reimburse yourself, as long as the fee doesn't exceed $150/month for individuals or $300/month for families.

Do DPC practices charge for after-hours calls?

No. After-hours phone or video consultations are typically included in your membership. This is one of DPC's most valuable benefits — having direct physician access when traditional offices are closed without paying ER or urgent care prices.

How does DPC pricing compare to concierge medicine?

DPC is significantly more affordable. The average DPC membership costs $1,100/year ($92/month) vs. $2,000-$10,000/year for concierge medicine. DPC achieves lower pricing by not billing insurance (eliminating administrative overhead), maintaining slightly larger patient panels, and offering fewer luxury services. For most patients, DPC provides 80% of the concierge experience at 30-50% of the cost.

Are there additional costs for families joining DPC?

Most DPC practices offer discounted family rates. A family of four typically pays $250-$400/month, which is less than four individual memberships. Children's rates are lower ($20-$75/month) than adult rates. Some practices also offer couple discounts of 10-15% off combined individual rates.

The Bottom Line

DPC monthly fees buy you unlimited, personalized primary care with transparent pricing. The model delivers exceptional value — 30-45 minute appointments, same-day access, and direct physician communication for roughly $3/day.

The key is understanding the boundaries: DPC covers primary care, not everything. Pair your membership with appropriate health insurance for specialist care, hospital stays, and emergencies, and you'll have a healthcare setup that's both higher quality and often less expensive than traditional insurance alone.

This article is educational and is not medical advice. Consult a licensed clinician about your individual care decisions. For help choosing between DPC and concierge medicine, read our full comparison.

Related Reading from our editorial team:

• Top 10 Concierge Medicine Companies Compared: Pricing, Access, Specialties (2026)
• Top 10 Cities for Concierge Medicine in the US Compared: Density, Cost, Top Practices (2026)
• Top 10 Concierge Medicine Membership Tiers Compared: $500 to $40K Annual Fees (2026)
• Top 10 Direct Primary Care (DPC) Practices in the US Compared (2026)
• Top 10 Concierge Medicine Services Compared: 24/7 Access, Executive Physical, Specialist Network (2026)

-- The DPC Finder Team