How to Price a Direct Primary Care Membership
How to price DPC memberships by age band, family size, and employer group — with the panel math that tells you if the numbers work.
Pricing a DPC membership feels like a clinical decision, but it is really a math problem. Get the monthly fee wrong and the panel fills up with a practice that still cannot pay you. Here is how I tell owners to think about it.
Start with the panel math, not the competition
Decide what the practice needs per month, then divide. If you need $40,000 a month and your panel cap is 600 patients, your blended fee needs to average about $67. Every pricing decision after that is just structuring around the average.
Price by age band
The most common structure: pediatric around $25–$45, adults $50–$100, and 65+ higher to reflect utilization. Age bands keep it fair, keep it simple to explain, and keep your blended rate honest.
Family tiers grow enrollment fast
A family tier at a per-member discount gets four members enrolled in one conversation instead of four. Cap the family price so the fourth kid is not full fare — enrollment rate matters more than squeezing the last $20.
From the field
The mistake I see most: pricing to match the practice down the road instead of pricing to your own panel math. Your cost structure, your visit length, your panel cap. Their number has nothing to do with whether yours works.
Employer pricing is volume pricing
For employer groups, quote a per-employee rate below your retail adult fee. You are trading margin for 25 enrollments at once and one consolidated monthly payment — that trade is almost always worth it.
The takeaway
Set the blended rate from your panel math, structure age bands and family tiers around it, and review the numbers quarterly. When you are ready to run the tiers on autopay, our direct primary care software builds and bills them for you.