What is the revenue per visit for a medical clinic?

This article was written by our expert who is surveying the industry and constantly updating the business plan for a medical clinic.

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The Dojo Business Team

A team of financial experts, consultants, and writers

We're a team of finance experts, consultants, market analysts, and specialized writers dedicated to helping new entrepreneurs launch their businesses. We help you avoid costly mistakes by providing detailed business plans, accurate market studies, and reliable financial forecasts to maximize your chances of success from day one—especially in the medical clinic market.

How many patient visits should a medical clinic expect each month?

A typical medical clinic handles between 700 and 900 patient visits per month.

This volume varies significantly based on your clinic size, specialty focus, and location demographics. Primary care clinics in densely populated urban areas tend to reach the higher end of this range, while specialty clinics or those in smaller communities may see fewer but higher-value visits.

The number of providers on your team directly impacts monthly volume—a solo practitioner clinic will naturally see fewer patients than a multi-provider practice. Your appointment scheduling efficiency, patient retention rate, and marketing efforts also play critical roles in determining actual visit numbers.

Seasonal patterns affect patient flow, with flu season and back-to-school periods typically driving higher volumes. Understanding your expected monthly visits helps you staff appropriately, manage supply inventory, and project cash flow accurately for your medical clinic's financial planning.

What revenue does each patient visit generate for a medical clinic?

Medical clinics generate an average of $100 to $200 in revenue per patient visit.

This figure represents the gross revenue before any adjustments, write-offs, or collection challenges. The actual amount depends on multiple factors including your geographic location, the complexity of services provided, and your payer mix distribution.

Clinics with a higher percentage of privately insured patients typically achieve revenue at the upper end of this range, while those serving predominantly Medicaid or self-pay populations may see lower per-visit revenue. The type of visit also matters—annual physicals, chronic disease management, and acute care visits each command different reimbursement levels.

Revenue per visit serves as a critical benchmark for measuring clinic performance over time. You'll find detailed market insights in our medical clinic business plan, updated every quarter.

What consultation fee should a medical clinic charge per visit?

How often do patient visits include additional billable services in a medical clinic?

Between 20% and 40% of all clinic visits include at least one additional billable service beyond the basic consultation.

These ancillary services encompass laboratory tests, diagnostic imaging, minor procedures, vaccinations, and other medical interventions performed during or immediately after the patient encounter. Industry data shows that 55% to 82% of medical practices now offer at least one type of ancillary service, recognizing the revenue potential and patient convenience benefits.

The percentage varies by specialty—primary care clinics performing routine health screenings and chronic disease management see ancillary service attachment rates toward the higher end. Urgent care facilities, which frequently handle acute conditions requiring immediate diagnostics, often exceed 40% attachment rates for services like X-rays, rapid tests, and minor wound care.

Your clinic's ancillary service utilization rate depends on available equipment, staff training, and the clinical appropriateness of offering these services during visits. Strategic ancillary service offerings increase convenience for patients while improving your revenue per visit substantially.

How much revenue do ancillary services add per visit at a medical clinic?

Ancillary services contribute approximately $15 to $22 in additional revenue per visit for primary care clinics.

This represents 11% to 15% of total clinic revenue when average revenue per visit is around $150. The calculation assumes that not every visit includes ancillary services, but when these services are provided, they generate significant incremental revenue that improves overall clinic profitability.

Common ancillary services include point-of-care laboratory testing (rapid strep tests, urinalysis, blood glucose monitoring), diagnostic imaging (X-rays, ultrasounds), immunizations, and minor procedures (suturing, lesion removal, joint injections). Each service type contributes differently to revenue—imaging typically generates higher fees than basic lab tests.

Clinics that strategically invest in ancillary service capabilities see improved patient satisfaction through one-stop care delivery and enhanced financial performance. This is one of the strategies explained in our medical clinic business plan.

What is the typical payer mix for medical clinic patient visits?

What reimbursement rates can a medical clinic expect from major payers?

Medical clinics receive reimbursement rates that vary dramatically based on the payer type and negotiated contracts.

Commercial insurance companies reimburse at 139% to 190% of the Medicare Fee Schedule, making them the most financially attractive payer category. Medicare establishes the baseline at 100% of its fee schedule, which serves as the industry standard for comparing all other reimbursement rates.

Medicaid programs reimburse at significantly lower rates, typically 60% to 75% of Medicare levels, creating substantial revenue pressure for clinics serving large Medicaid populations. These lower rates often don't cover the full cost of care delivery, forcing clinics to subsidize Medicaid patients through revenue from better-paying commercial insurance patients.

The reimbursement rate differences explain why payer mix matters so critically to clinic financial health. A clinic with 60% commercial insurance will generate substantially more revenue per visit than one with 60% Medicaid, even if both see the same patient volumes and provide identical services. We cover this exact topic in the medical clinic business plan.

What collection rate should a medical clinic achieve after adjustments and write-offs?

High-performing medical clinics achieve net collection rates between 90% and 95% after all contractual adjustments and write-offs.

This metric measures the percentage of expected collectible revenue that actually gets deposited into your clinic's bank account. The "expected collectible revenue" excludes contractual adjustments—the difference between your charged fees and the agreed-upon insurance reimbursement rates—so you're measuring efficiency on the revenue you should realistically collect.

Collection rates below 90% indicate problems with billing processes, follow-up procedures, patient payment collection, or insurance verification. Common issues include incomplete documentation, coding errors, lack of prior authorizations, and inadequate patient financial counseling at the time of service.

Improving your net collection rate directly increases revenue without seeing additional patients. A clinic with $1 million in collectible revenue improves cash flow by $50,000 annually when moving from an 85% to a 90% collection rate. Consistent monitoring of this metric and addressing collection barriers should be a top priority for every medical clinic.

How do denied claims affect medical clinic revenue per visit?

Between 10% and 20% of medical claims are initially denied by insurance payers, creating significant revenue disruption for medical clinics.

Over half of these denied claims are never reworked or resubmitted, resulting in a permanent revenue loss of 3% to 4% of total patient revenue. The administrative cost to rework a single denied claim averages $57, adding substantial overhead expense that further erodes profitability beyond the lost revenue.

Common denial reasons include missing or incorrect patient information, lack of prior authorization, coding errors, timely filing violations, and medical necessity disputes. The financial impact compounds when you consider both the lost revenue and the staff time required to investigate, correct, and resubmit claims.

Clinics with strong front-end revenue cycle management—including thorough insurance verification, accurate coding, proper documentation, and proactive authorization management—significantly reduce denial rates. Investing in denial prevention delivers better returns than investing in denial management, as preventing denials in the first place avoids both the revenue loss and the rework costs.

What does each patient visit cost to deliver in a medical clinic?

The all-inclusive cost per patient visit ranges from $80 to $110 for medical clinics.

This encompasses both direct costs and allocated overhead expenses. Direct costs include clinical staff salaries (physicians, nurses, medical assistants), medical supplies and consumables used during the visit, and the time-based portion of equipment utilization.

Overhead costs allocated to each visit include facility rent or mortgage payments, utilities, administrative staff salaries, medical malpractice insurance, health information technology systems, billing services, and general business expenses. These fixed costs must be spread across all patient visits, so higher visit volumes reduce the per-visit overhead burden.

Understanding your true cost per visit is essential for evaluating profitability by payer type and service line. If your average cost is $95 per visit but Medicaid reimburses only $75, you're losing $20 on every Medicaid patient seen. This cost analysis should inform your payer contracting strategy and operational efficiency improvement initiatives. It's a key part of what we outline in the medical clinic business plan.

What net revenue remains per visit after all medical clinic costs are covered?

How has medical clinic revenue per visit changed over the past year?

Revenue per visit for medical clinics has remained relatively stable with modest increases of 2% to 6% over the past 12 months.

Several positive factors are driving revenue growth. Increased utilization of ancillary services—as more clinics invest in point-of-care testing and diagnostic equipment—adds incremental revenue per visit. The growing complexity of patient visits, reflected in higher evaluation and management (E/M) coding levels, also contributes to improved revenue as payers reimburse more for comprehensive care.

Mild fee schedule adjustments by commercial insurers and Medicare, intended to offset inflation and rising practice costs, provide some revenue relief. However, these increases often lag behind actual cost inflation, creating margin pressure even as gross revenue per visit increases modestly.

Working against revenue growth, increasing claim denial rates and lengthening payment cycles create downward pressure on net collections. Administrative burden continues to rise, with payers implementing more stringent prior authorization requirements and documentation demands that slow payment and increase the risk of denials.

The trend suggests that clinics cannot rely on passive revenue growth and must actively manage their revenue cycle, optimize coding accuracy, expand strategic ancillary services, and negotiate favorable payer contracts to maintain profitability in the current healthcare environment.

Conclusion

This article is for informational purposes only and should not be considered financial advice. Readers are encouraged to consult with a qualified professional before making any investment decisions. We accept no liability for any actions taken based on the information provided.