Pricing guide
How much does a medical director cost?
Owners crowdsource this number in Facebook groups because vendors will not state it plainly. Here is what the market actually charges, why quotes for the same role run from a few hundred dollars a month to several thousand, and the part of the bill many programs do not need to pay at all.
The short answer
It depends on which of two things you are buying, and most quotes do not say which.
Oversight is priced by the month. A medical director, collaborating physician or supervising physician charges a retainer for taking clinical responsibility for your practice: signing protocols, reviewing charts, holding the agreement your state requires, being reachable.
Patient-facing clinical work is priced per encounter. The consult, the good-faith exam, the prescription decision, the follow-up: those are bought one at a time, or by the hour. A retainer very often does not include them.
| Arrangement | What owners report | What is usually inside it |
|---|---|---|
| Remote medical director or collaborating physician, one provider, hands-off | $400 to $2,000 a month | Protocol sign-off, periodic chart review, reachable for questions. The most common quote owners share with each other. |
| Engaged director for several providers, on-site visits or higher-risk services | $3,000 to $6,000 a month, sometimes more | Fees in this band usually mean multiple injectors or NPs, physical presence, or controlled substances in scope. |
| Per-encounter clinical work in telehealth listings | Roughly $20 to $50 per consult or exam | Intake review, video visit or good-faith exam, paid per completed encounter. Often quoted with a small platform fee on top. |
| Hourly medical-director or clinical time | $150 to $250 an hour | Used for audits, protocol builds and emergency calls; some physicians quote a flat fee per emergency call instead. |
| Revenue share or equity | Single-digit to double-digit percentages of gross | Sometimes with an upfront fee and a multi-year term. Owners in the corpus push back hardest on this model. |
Figures are what med spa owners, NP practice owners and buyer-authored job listings reported in public forums and posts between 2023 and 2026, compiled in StaffMD’s market study. They are not StaffMD prices and they are not a quote. Your state, scope and provider count move them a long way.
Why the same role gets quoted at $500 and $5,000
- 01
State rules.
Restricted-practice states require nurse practitioners to hold a collaborative agreement, and some cap how many NPs one physician may collaborate with. Scarcity raises the fee; owners report a state residency requirement alone adding a couple of hundred dollars a month to a marketplace rate.
- 02
What the physician is actually on the hook for.
Protocol sign-off and quarterly chart review is one price. Same-day availability for questions, prescriptions and signatures is another. On-site presence is a third.
- 03
How many providers sit under the agreement.
Fees that climb into the thousands usually mean several injectors or NPs, each of whom the physician has to add to their liability coverage.
- 04
Service mix.
Injectables, IV hydration, weight management, hormone therapy and controlled substances each change the liability picture and the paperwork: standing orders, pharmacy accounts, prescription monitoring. The price follows.
- 05
Whether the clinical work is included.
Many retainers cover oversight only; every patient encounter is extra, or is expected to be done by your own staff. Two quotes that look identical can differ entirely on this one line.
- 06
Who carries the malpractice.
Some owners pay the director’s professional liability coverage on top of the retainer. Some directors carry the practice under their own policy for a higher fee.
- 07
Startup phase.
Several listings and owner reports describe a lower fee for the first few months while volume is low, then a step up once the practice is running.
The pricing models you will be offered
| Model | What it buys | Where it fits | The catch |
|---|---|---|---|
| Monthly retainer | Availability and accountability from a named physician | Statutory oversight, protocol ownership, a director who answers the phone | Paid whether or not anyone sees a patient. Consults usually cost extra. |
| Per provider or per location | Oversight scaled to headcount | Multi-injector or multi-site practices | Rises with staff, not with revenue. |
| Hourly | Time, including emergency calls, chart reviews and protocol builds | Ad hoc oversight, audits, one-off projects | Unpredictable, and hard to plan around before you have volume. |
| Per consult, per exam | A completed patient encounter by a licensed clinician | Programs whose volume varies, is seasonal, or is still unproven | Does not, on its own, satisfy a state oversight requirement. |
| Revenue share or equity | A physician with a stake in your growth | Founders who cannot fund a fee before revenue | The cost grows with every sale, for as long as the term runs. Owners describe upfront fees and multi-year lock-ins alongside the percentage. |
The part of the bill you may not need to pay
Most owners arrive at this question with one budget line, “the doctor”, and two very different needs hidden inside it.
If your gap is oversight, you need the retainer. A per-consult clinician cannot sign the collaborative agreement your board requires, and anyone who suggests otherwise is selling paper compliance.
If your gap is throughput, patients waiting for evaluations, follow-ups backing up, a director who signs charts monthly but does not see anyone, then a retainer is the wrong instrument. You would be paying a fixed fee for idle capacity and still doing the consults yourself, or hiring for them.
Many programs need both. The expensive mistake is buying them as one item, from one vendor, at one price. Split them. Price the oversight as oversight, and price the consults per consult.
Run your own numbers
Take any retainer quote you have been given and spread it across the consults it would actually have to cover. Then compare it with any per-consult quote. The breakeven is the monthly volume below which paying per consult costs less.
- Retainer, per consult
- —
- what each consult costs if the retainer has to cover them all
- Per-consult model, per month
- —
- your quoted rate times your expected volume
- Breakeven volume
- —
- below this many consults a month, the per-consult model costs less
This compares money only. A retainer that buys medical direction and a per-consult rate that buys patient encounters are different products, and most retainers do not include the encounters at all.
How StaffMD prices clinical coverage
Rates are not published here because they vary by service line, state and volume. The coverage call ends with a written per-consult rate you can put next to the retainer quotes above. It is the same form that runs the rest of StaffMD’s clinical coverage.
- One flat rate per completed consult, quoted for your service lines, your states and your expected volume.
- No retainer, no setup fee, no minimum volume and no percentage of your revenue.
- You pay for completed consults, not for scheduled hours or idle capacity.
- A short agreement. Scale up or down with your patient volume.
Questions owners ask before they sign
Book a Coverage Strategy Call
Tell us your states, protocols and expected volume. We come back with a coverage plan and your per-consult rate.