How much does medical billing cost?
Short answer: Most outsourced medical billing companies charge a percentage of what they collect. In Tebra's 2026 survey of 190 respondents from US billing companies, 63% of those using percentage pricing charged 7.99% or less of collections. Some companies charge per claim or a flat monthly fee instead.
The rate on its own does not tell you the real cost. What the percentage is charged on, what work it covers, and which fees sit outside it matter just as much.
VeroRCM typically charges 3–4% of collections, with no setup fee and no monthly minimum.
How billing companies charge
| Model | How it works | What to watch |
|---|---|---|
| Percentage of collections | A share of what the billing company actually collects for you | What the percentage is calculated on, and whether there is a monthly minimum |
| Per claim | A fixed fee for each claim submitted | You pay whether or not the claim is paid. Resubmissions may count as new claims |
| Flat monthly fee | A set amount every month | Volume caps, and what happens to follow-up when volume rises |
| Hybrid | A base fee plus a lower percentage, or a percentage with a minimum | Run the math at your actual volume |
Percentage-of-collections pricing aligns the billing company's fee with what the practice actually collects. It is also one of the most common pricing models used for full-service medical billing.
What the survey data shows
Published pricing data for this industry is limited. The most recent survey is Tebra's 2026 Medical Billing Benchmark Report, fielded December 1–17, 2025, with 190 respondents from US medical billing companies. Among companies using percentage pricing:
| Rate charged | Share of billing companies |
|---|---|
| 4.99% or less | 12% |
| 5–5.99% | 19% |
| 6–6.99% | 16% |
| 7–7.99% | 16% |
| 8–8.99% | 5% |
| 10% or more | 4% |
Another 28% did not use a percentage model at all. The same survey found 39% of billing companies always or often charge setup fees.
These figures are self-reported by billing companies, not a random sample of practices. Use them as a reference point, not a price list.
What should be included in the price
Before you compare percentages, get the scope in writing. Depending on the arrangement, a full-service medical billing service may include:
- Charge entry or charge review, and claim submission
- Claim scrubbing and rejection follow-up
- Payment posting
- Denial follow-up and appeals
- A/R follow-up by payer and age
- Patient statements
- Monthly reporting with claim-level detail
Two quotes at the same percentage can be very different deals when one includes appeals and A/R follow-up and the other does not.
For a fuller checklist, see questions to ask a medical billing company before you hire them.
Fees to ask about
Ask whether any of these are billed separately:
- Setup or implementation fees
- Old A/R cleanup on claims from before the start date
- Credentialing and enrollment
- Clearinghouse or statement costs
- Patient phone support
- Monthly minimums
- Termination or data-export fees
At VeroRCM: no setup fee, no monthly minimum, and no extra charge to work old A/R. Patient statements are included. Credentialing is free for the first year when you use our billing service.
In-house vs outsourced billing
In-house billing is not free just because there is no percentage on the invoice. Its cost includes salaries, benefits and payroll taxes, software, clearinghouse fees, training, supervision, coverage when someone is out, and the revenue lost when follow-up falls behind.
Use the calculator below with your own numbers. The defaults are examples only.
Example numbers shown. Replace them with your own. Nothing you enter leaves your browser.
| In-house billing cost per year | – |
| Effective in-house cost as % of collections | – |
| Outsourced billing cost per year | – |
| Difference per year | – |
This compares cost only. It does not include differences in what each option collects, such as denials worked, underpayments caught, or A/R that ages out.
The lowest fee is not always the lowest cost. A billing operation that misses appeal windows or never checks paid claims against contracted rates can cost far more than the difference between 4% and 7%.
To see what denials alone may be costing, try the denial cost calculator.
How VeroRCM prices
VeroRCM typically charges 3–4% of collections for full-service medical billing for independent physician practices.
That rate comes with:
- No setup fee
- No monthly minimum
- No extra charge to work old A/R
- Patient statements included
- Free credentialing for your first year of billing with us
Technology helps us surface what deserves attention. Experienced billing professionals review the findings and do the actual work.
We work inside the EHR your practice already uses, including athenahealth, eClinicalWorks, Tebra and ModMed.
If you are thinking about switching billing companies, or just want a second look, start with the free Revenue Leak Audit. It shows where revenue may be slipping before you decide whether anything needs to change.
Common questions about medical billing cost
How much do medical billing companies charge?
Most charge a percentage of collections. In Tebra's 2026 survey, 63% of billing companies using percentage pricing charged 7.99% or less. Per-claim and flat monthly pricing are also common. Compare scope and extra fees, not just the headline rate.
Is percentage-of-collections pricing charged on net or gross?
Percentage-based billing is commonly calculated on collections actually received by the practice, but the agreement should define the calculation clearly. Confirm what revenue is included before comparing rates, because a percentage applied to charges would produce a very different result.
Is it cheaper to bill in-house?
Not always. Add up salaries, benefits, software, clearinghouse fees, coverage and turnover, then compare. Also look at what each option collects, not just what it costs.
Do billing companies charge setup fees?
Many do. In Tebra's 2026 survey, 39% of billing companies always or often charge setup fees. Ask for every one-time and recurring fee before signing.
What does VeroRCM charge?
VeroRCM typically charges 3–4% of collections. There is no setup fee, no monthly minimum, and no extra charge for old A/R. Patient statements are included, and credentialing is free for the first year when you use our billing service.