Lab Partners for DPC Practices¶

Quick Summary: Direct-pay lab pricing can save your patients a large share of what hospital-based labs charge (savings of 50-90% are commonly cited). Building relationships with labs is essential for DPC practices.

Two Rules Before You Sign Anything¶

Labs do not need a business associate agreement. A laboratory that runs the tests you order is a HIPAA covered entity in its own right, and your order is a treatment disclosure, so no BAA is required between you and the lab. Do not let a lab's sales team (or your own caution) hold up account setup over one. See BAA Requirements for the citation and for the vendors that do need one.

Pass-through lab pricing must be offered to members and non-members alike. Under the 2026 HSA rules (IRS Notice 2026-05, Q&A-11 and Q&A-12), items you bill separately but make available only to members are treated as part of the DPC arrangement. If your lab prices are members-only, a member with a high-deductible health plan can lose HSA eligibility. Publish one lab price list and honour it for anyone who walks in with an order. The HSA note in Pricing Your Practice covers the fee caps and the bundling limits that go with this.

Lab Partnership Options¶

The two national reference labs are listed first because most practices start with one of them, not because the kit recommends either. A regional lab may be cheaper, faster or more responsive in your market; compare before you sign.

National Reference Labs¶

Quest Diagnostics¶

DPC-friendly: Yes

Account setup: - Direct physician account available - No minimum volume requirements - Online ordering portal

Pricing: - Negotiated cash pricing for DPC - Often 50-80% less than hospital labs - Volume discounts possible

Patient draw options: - 2,000+ patient service centers - Some offer in-office phlebotomy support - Mobile phlebotomy in some markets

Contact: Quest Diagnostics client services (questdiagnostics.com)

Labcorp¶

DPC-friendly: Yes

Account setup: - Physician office accounts - Patient pay accounts - Simple enrollment process

Pricing: - Competitive cash rates - Published patient pricing available - Negotiation possible for volume

Patient draw options: - 2,000+ locations nationwide - At-home collection in some areas

Contact: Labcorp client services (labcorp.com)

Regional Lab Options¶

Check your area for regional labs that may offer: - Better local pricing - Faster turnaround - More personalized service - In-office pickup

Examples of regional labs (names checked 2026-09-22): - ARUP Laboratories (Utah/Mountain West) - Sonic Healthcare USA (nine regional divisions across 34 states, including Clinical Pathology Laboratories in Texas and the South; sonichealthcareusa.com) - BioReference Health (New York/New Jersey core clinical testing; its oncology testing business was sold to Labcorp in September 2025, so confirm which entity now serves your area: Labcorp announcement) - Hospital-system outreach labs in your area, which sometimes offer client pricing to independent practices

Direct-to-Consumer Labs¶

For patient self-ordering (supplement your testing):

These are patient-facing services. They are useful when a patient wants a test you would not order, or lives far from your lab's draw sites; they are not a substitute for your own lab account.

In-Office Testing¶

Point-of-care options to reduce lab referrals:

CLIA considerations: - Waived tests require a CLIA certificate of waiver ($248, renewed every two years) - Simple application process (CMS Form 116 through your state agency) - Minimal ongoing requirements, but only tests on the FDA's CLIA-waived list qualify; check before you buy a device

Typical Lab Pricing (Cash Pay)¶

These are approximate ranges - negotiate for your practice:

Your cost = What you might negotiate with volume or a DPC client account. Whatever you charge on top of it, charge the same price to non-members (see the HSA rule above).

Setting Up Lab Accounts¶

Quest/Labcorp Process¶

1. Contact physician services
2. Complete application (practice info, NPI, license)
3. Choose billing model:
4. Bill patient directly (they pay at the patient service center)
5. Bill practice (client billing; you collect from the patient, with or without a markup)
6. Patient pay with negotiated rate
7. Skip the BAA request if one is offered; it is not required for a lab (see above)
8. EMR integration (if desired)
9. Receive supplies (if doing in-office draws)

Negotiation Tips¶

• Mention DPC specifically - Labs want this volume
• Ask for DPC pricing - Different from standard cash pay
• Discuss volume projections - Even small panels matter
• Request price list - Get it in writing
• Ask about new tests - Get additions at same rates
• Annual review - Renegotiate periodically

Lab Workflow Models¶

Model 1: Patient Pays Lab Directly¶

How it works: - You order test - Patient goes to PSC - Patient pays lab's cash price

Pros: - Simplest for you - No accounts receivable - No markup hassle

Cons: - Less control over pricing - Patient may be surprised by cost - Can't build in convenience

Model 2: You Bill Patient, Pay Lab¶

How it works: - You order test - Patient pays you (at time of order or adds to membership) - Lab bills you - You pay lab

Pros: - Control pricing - Can markup modestly - Bundled patient experience

Cons: - Accounts receivable - Cash flow management - More bookkeeping

Model 3: In-Office Draws, Send Out¶

How it works: - Draw in your office - Courier picks up - Lab runs and bills you

Pros: - Convenient for patients - All-in-one visit - Can do some POCT in-house

Cons: - Phlebotomy supplies/training - Courier coordination - Specimen handling

Presenting Lab Costs to Patients¶

Transparency Approach¶

Provide price list of common tests: - "Here's what we charge for labs" - "Compare to what you'd pay elsewhere" - Emphasize savings

Bundled Approach¶

Include common labs in membership: - Annual wellness labs included - Acute labs at cost - Premium tier with more included

At-Cost Approach¶

Pass through at your cost: - "We don't mark up labs" - Builds trust - May lose some revenue - The cleanest fit with the 2026 HSA rules, provided the same price list is available to non-members

EMR Integration¶

Most DPC EMRs advertise connections to the major labs. Examples (not a ranking; confirm the current list with each vendor before you sign):

Ask two questions of every vendor: which labs are connected in your state, and whether the interface is bidirectional (orders out and results back) or results-only.

Integration benefits: - Electronic ordering - Results in chart automatically - Fewer phone calls - Better tracking

Specialty Labs¶

When to Use Specialty Labs¶

Cost consideration: Specialty labs are expensive, and some of this testing has limited evidence behind it. Use judiciously, and price it to the patient the same way whether or not they are a member.

Common Lab Challenges¶

"Why Can't I Use My Insurance?"¶

Explain: - We get you better cash prices - Until you meet your deductible, the insurance-billed price is often higher than our cash price - No surprise bills - You can still pay with HSA or FSA funds; labs are a qualified medical expense - If you would rather use insurance, we can send the order to the lab that way and you pay the lab directly

Patient No-Shows for Labs¶

Solutions: - In-office draws - Strong follow-up - Include in annual visit - Explain importance

Getting Results to Patients¶

Options: - EMR patient portal - Secure messaging - Phone call for abnormals - Scheduled follow-up visit

Related Guides¶

• Lab & Imaging Integration
• Equipment & Supplies Checklist
• Pricing Your Practice (HSA fee caps and the pass-through rule)
• BAA Requirements (why labs do not need one)

Good lab partnerships are one of the tangible values you provide. Saving patients hundreds on a simple panel demonstrates the DPC difference.

Read through and figures checked on 2026-09-22.