General information for licensed practices, not legal, financial, regulatory or medical advice. Have your counsel and accountant review your financial policy.
This piece supports our complete guide to building a cash pay wellness service line in functional, integrative and primary care.
What does "cash pay" mean for a functional medicine practice?
Cash pay means the patient pays the practice directly for a defined service. The practice sets the fee, posts it and collects it at or before the visit. Payment can be by card or other methods your practice accepts. "Cash" describes who pays, not the payment method.
In the model we describe, wellness services are offered as cash pay only. We don't describe any service as billable to a health plan, and we suggest you don't either.
What are the common cash pay payment models?
Most practices use one or a blend of these:
- Per visit fee. A posted fee for each visit or service. Simple to explain and simple to run.
- Packaged service. A defined set of visits or services for one posted fee, with a written description of what's included and what isn't.
- Recurring membership. A periodic fee for defined access, such as visit availability or messaging. Direct primary care practices often use this structure. The AAFP describes direct primary care as a model in which patients pay the practice a periodic fee directly.
- Add-on services. A separately priced service, such as a lab or DNA test, added to any of the above with its own posted fee.
Whatever you choose, write down exactly what the fee covers. Vague "all inclusive" language is where patient confusion starts.
What does a sound cash pay model include?
Use this checklist before you launch or change a payment model:
- Posted fees for every service, visible before the patient commits.
- A signed financial policy that says services are cash pay and explains refunds and cancellations.
- A written scope for each package or membership: what's included, what's extra, how long it lasts.
- Good faith estimates where they apply. CMS guidance under the No Surprises Act covers estimates for uninsured and self pay patients.
- Clear cancellation terms for any recurring fee, reviewed by counsel against your state's rules.
- Separate pricing for products and tests, so the patient knows what they are paying for.
- Staff scripts that describe the service and the fee, never a result.
- Counsel review of the policy, the scope documents and your website copy.
Can you do functional medicine and accept insurance?
That's a business and legal decision for each practice, and it involves payer contracts and, for Medicare, specific opt out rules. It's outside what we cover. The service lines we support are cash pay only, and the content on this site is written for that model. Talk with your counsel and billing advisor about your own situation.
Is integrative medicine covered by insurance?
We don't advise on coverage. For the wellness services we support, the answer to give patients is simple and accurate: these services are cash pay, with posted fees, and the practice doesn't bill a health plan for them. Put that in the financial policy and on the website.
How do you add a cash pay wellness service line to an existing model?
Treat it as its own line, with its own fee, scope and owner:
- Name a clinical owner. One licensed provider owns the service, and every treatment is prescribed and supervised by your licensed provider after an evaluation.
- Price it separately. Post the fee and decide whether it stands alone, sits in a package or is an add-on to a membership.
- Write the paperwork. Update the financial policy, consent and scope documents.
- Set up sourcing. Use one licensed source for products and tests so ordering and documentation stay consistent.
- Train the team. Front desk scripts describe the service and fee, and clinical questions go to the provider.
Our sibling piece on adding wellness services to a direct primary care practice walks through the membership case.
What should a practice avoid?
- Income or return promises in recruiting, investor or staff materials.
- Outcome language in package names or descriptions.
- Insurance implications, including "may be reimbursed" or coverage hints.
- Inducements such as discounts or rewards tied to referrals.
- Hidden fees that aren't in the posted fee or scope.
Where does RevMed fit?
We're an independent RevMed Group distribution partner based in Raleigh, and we help functional, integrative and DPC practices across the Triangle open a RevMed account. We don't give clinical, legal or financial advice.
Verification, ordering and fulfillment run through RevMed, which works with licensed, vetted pharmacy and laboratory partners. Once you're verified through RevMed, existing practices can be ordering within about 48 hours. If you're adding a new wellness line, RevMed's launch team can build it with you.
Two terms used here: license and NPI verification means RevMed confirms your practice's professional license and National Provider Identifier (NPI) before the account can order. Our Partner Link is the referral link we share so your RevMed account application is tied to PeptidesPlus Clinical.
The plan:
- Book a 15 minute intro with us.
- Get verified through RevMed using our Partner Link.
- Launch with RevMed, with your counsel signing off on your financial policy.
Common questions
What is the most common payment model for functional medicine?
Practices vary. Per visit fees, packages and memberships are all common, and many practices blend them.
Does cash pay mean patients pay in cash?
No. It means the patient pays the practice directly. Card and other methods are typical.
Do we need a written financial policy?
Yes. A signed policy that says services are cash pay and explains refunds is a basic safeguard. Have counsel review it.
Can a membership include products or tests?
Some practices price them separately for clarity. Whatever you choose, write the scope down and have counsel review it.
What is a good faith estimate?
A written estimate of expected charges that providers give uninsured and self pay patients under the No Surprises Act. See CMS guidance for when it applies.
Can HSA or FSA cards be used for cash pay services?
Sometimes, depending on the account and the service. Patients check eligibility with their plan administrator. The practice doesn't bill a health plan and doesn't promise eligibility.
Next step
Adding a cash pay wellness line? Book a 15 minute intro.