This page is for independent clinicians and small practices that bill patients directly: cash-pay and direct primary care practices, mobile nurses, private-duty nurses, independent therapists and physical therapists, and clinics that collect copays, deductibles, or self-pay fees. Invoices usually cover visits, procedures, point-of-care tests, supplies, and memberships or care packages. If you also bill insurance, the patient-facing invoice or statement covers only what the patient owes.
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Invoice_1001_Client_2026-10-14.pdf
Pricing in private-pay healthcare is mostly per visit, with the fee set by visit length and complexity (new patient vs. follow-up, 20, 40, or 60 minutes). Private-duty and home nursing is usually billed hourly, often with a 2 to 4 hour minimum and higher rates for nights, weekends, and holidays. Direct primary care and concierge practices charge a monthly or annual membership that covers a defined set of services. Procedures, in-office tests, injections, and supplies are listed as separate line items. Telehealth visits are often priced a little below in-person visits. Many solo providers publish a fee schedule and list the same fee for each service every time. Where insurance is involved, the patient's portion is set by the plan, and you bill the allowed amount, copay, or deductible rather than your cash rate.
| Service | Priced | Typical range |
|---|---|---|
| New patient visit (45-60 min) | per visit | $150-350 |
| Follow-up office visit (20-30 min) | per visit | $75-200 |
| Telehealth visit | per visit | $60-150 |
| Private-duty nursing (RN) | per hour | $40-90 |
| Mobile nurse home visit (blood draw, injection, wound care) | per visit | $75-200 |
| Point-of-care tests and supplies (A1c, strep, urinalysis) | per test | $15-60 |
| Injection administration (vaccine or medication cost billed separately) | per injection | $25-60 |
| Direct primary care membership | per month | $75-150 |
Typical US ranges. Rates vary by region, experience, and job size.
| Description | Qty | Rate | Amount |
|---|---|---|---|
| New patient visit, 60 minutes, comprehensive history and exam (DOS 03/04) | 1 visit | $250.00 | $250.00 |
| Point-of-care hemoglobin A1c test | 1 test | $35.00 | $35.00 |
| Vaccine administration, influenza (vaccine billed at cost: $28) | 1 injection | $40.00 | $40.00 |
| Influenza vaccine, supply cost | 1 dose | $28.00 | $28.00 |
| Follow-up telehealth visit, 20 minutes, lab review (DOS 03/18) | 1 visit | $95.00 | $95.00 |
| Total | $448.00 | ||
Notes: Self-pay patient. Amount due within 30 days of statement date. A superbill with CPT and ICD-10 codes is available on request for out-of-network reimbursement. Payment accepted by card, HSA/FSA card, or check. Questions about this statement: call the office during business hours.
Patients, HSA/FSA administrators, and insurers all need exact dates. A single total with no dates is often rejected for reimbursement.
Out-of-network claims and HSA/FSA reimbursements usually require the rendering provider's identity and NPI.
Codes make the charges clear and let patients submit a superbill to their plan. Use the code that matches the service you actually performed.
Include ICD-10 codes on a superbill the patient will submit, but keep detailed clinical information off a routine invoice to limit exposure of protected health information.
Pass-through costs should be visible and match what you quoted, and some are billed at cost rather than at your service rate.
Patients need to see what was paid, what was written off, and what they still owe, or they will call to dispute the balance.
Healthcare invoices carry sensitive data, so give clear payment options and avoid asking patients to send card numbers by email or text.
Most cash-pay practices collect payment at the time of service by card, HSA/FSA card, or ACH, and send an invoice only for balances or services billed afterward. Membership practices bill monthly or annually in advance, often by automatic card charge. Home nursing and private-duty care are commonly billed weekly or biweekly with net 7 to 14 day terms. For insurance copays and deductibles, statements are typically due in 30 days. Late fees and collections are allowed in many places but are regulated, so put your policy in writing at intake, keep fees modest, and check your state rules before sending an account to collections. Many practices also charge a fee for no-shows or late cancellations (often $25 to $100, or the visit fee for longer appointments) if the patient agreed to it in advance.
Unpaid balances are the biggest cash flow problem for small practices. Keep a card on file with written consent, or collect the visit fee at check-in or check-out, so you aren't chasing small amounts later.
Many patients with out-of-network benefits or HSA/FSA accounts need codes and your NPI to be reimbursed. Giving it automatically cuts follow-up requests and makes patients more likely to return.
Have patients sign the policy at intake, state the notice period (commonly 24 hours), and list the fee. A signed policy is much easier to enforce than a verbal one.
Invoices should show services, codes, and amounts, not clinical details. Store billing records in a system that meets your privacy obligations, and send them only through secure channels.
Keep a copy of the estimate or fee schedule you gave the patient. If the invoice differs, note why, such as a longer visit or an added test the patient agreed to.
Not for a routine self-pay invoice. Diagnosis codes are needed on a superbill the patient will submit to their insurer. If you include them, share the document only with the patient or their authorized representative, through a secure method.
Professional medical services are exempt from sales tax in most states, but rules vary, and some taxable items, such as certain retail products or supplements, may be charged tax. Check with your state department of revenue or a tax professional.
In most cases yes, if the patient was told about the fee in writing beforehand. Some payers and states restrict no-show fees for insured patients, so check your contracts and local rules.
Collect your fee from the patient, then give them a superbill with dates of service, CPT and ICD-10 codes, your NPI, and the amount paid. The patient submits it to their insurer for any out-of-network reimbursement. Reimbursement is not guaranteed.
Retention periods vary by state and by payer, and are often several years or longer. Check your state medical board and any insurance contracts, and keep records longer for minors.
Send a Healthcare estimate for approval, then turn it into an invoice when the work is done.
Healthcare estimate template