Direct Pay
Patient pays New Century Labs directly for lab testing.
PatientNew Century Labs
How Clinics Can Offer Cash-Pay Labs Without the Billing Guesswork
Compare Direct Pay, Service Fee, and Self-Managed workflows so your clinic can offer transparent lab testing and capture the value of real service work where appropriate.
New Century Labs supports all three billing workflows: Direct PayService FeeSelf-Managed Pricing
Educational overview, not legal advice · Last reviewed July 2026 · Choose a starting point here, then confirm it with counsel.
Plain-English answer
Yes — most clinics can offer cash-pay lab testing without taking on a billing operation. The usual starting point is Direct Pay: the patient pays the lab directly and your clinic never touches the lab bill. Clinics doing real consultative or administrative work can add a clearly disclosed Service Fee, and some states allow practice-managed pricing. Your state’s rules decide which workflows fit.
Three billing workflows
Direct Pay, Service Fee, and Self-Managed Pricing
Service Fee
Clinic may charge a transparent fee for professional/admin services.
PatientNew Century Labs + Clinic fee
Self-Managed Pricing
Clinic controls patient pricing where state law and payer context allow.
PatientClinicNew Century Labs
Offering cash-pay labs is not just a pricing decision. It is a billing workflow decision, and the wrong model creates confusion for patients, staff, and compliance review. New Century Labs supports three workflows so your clinic can offer transparent lab testing, capture the value of the work it actually performs, and choose a billing model that matches your state, payer mix, and practice structure.
This guide is for independent clinics, concierge practices, functional medicine and naturopathic doctors, telehealth providers, med spas, and cash-pay or hybrid practices. It is not for hiding charges, billing insurance incorrectly, or referral-linked compensation — none of the workflows here support that.
Why the billing model matters
A clinic charging for its own work is different from a clinic profiting on lab services performed by an independent lab. That distinction drives most of the analysis, and federal law sharpens it: the Anti-Kickback Statute and the Stark self-referral rules make referral-linked compensation risky, especially with Medicare or Medicaid patients. A clean workflow shows who performed what and what the patient is paying for.
Explaining each model to patients
The wording your front desk uses matters as much as the structure:
Direct Pay — “Your lab order is processed through New Century Labs, and you pay New Century Labs directly for the lab testing.”
Service Fee — “Your lab testing is billed through New Century Labs. Our clinic charges a separate service fee for our clinical review, ordering support, and follow-up.”
Self-Managed — “Our clinic manages the billing for this lab order. Your invoice will show the applicable lab and clinic charges under our billing policy.”
State law decides more than you’d expect
Some states expect the lab to bill the patient directly, some cap what a clinic can add to an outside lab’s charge, some require disclosure, and some have no specific rule identified. That is exactly why New Century Labs supports three workflows instead of one. Find yours in the state-by-state guides.
Medicare patients
New Century Labs’ cash-pay workflow is intended for non-covered or patient-requested testing where Medicare is not billed; covered, medically necessary services require a different billing analysis. The Medicare guide covers that boundary and the cleaner structures.
Estimate
Compare patient cost and service-fee impact
Choose your starting point, then confirm it with counsel. The right model depends on your state, payer mix, and patient population.
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Common lab test mix
Based on frequently ordered tests across New Century Labs practices.
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Common lab test mix
How you bill patients
Patient pays New Century Labs directly
Add a transparent service fee
$
You control patient pricing
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Estimated patient savings
For your practice
$0
saved per patient
Your patient pays $0 instead of $0 when insurance falls short.
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How you can bill for lab work is regulated and varies by state. You're responsible for choosing a model that complies with your state's rules. This is an illustration, not legal advice; we'll help you find the right fit on the call.
Ready to choose a model?
The comparison guide walks through when to use Direct Pay, when a transparent Service Fee makes sense, and when Self-Managed pricing needs legal review — with scenarios and a decision table.
Common mistakes to avoid
- Treating every state the same.
- Hiding clinic fees inside lab prices instead of disclosing each charge for what it is.
- Using percentage-based fees without review.
- Treating Medicare-sensitive cases like ordinary cash-pay.
FAQ
Can a clinic charge more than the lab’s price?
It depends on the state, payer, and billing structure. The cleaner question is whether the clinic is charging for its own work, versus profiting on an outside lab’s service — most states draw the line somewhere around that distinction.
Is a service fee the same as a lab markup?
No. A service fee pays the clinic for work it actually performs, clearly disclosed to the patient. A markup is profit on the lab’s own work — that difference matters in most states.
Can clinics use cash-pay labs for Medicare patients?
For non-covered or patient-requested testing where Medicare is not billed, often yes — with extra care around disclosures and referral-linked compensation. See the Medicare guide.
Does New Century Labs guarantee legal compliance?
No. New Century Labs provides the workflows and guardrails; clinics and their counsel choose the appropriate model.
Sources and further reading
- HHS OIG, Fraud & Abuse Laws: https://oig.hhs.gov/compliance/physician-education/fraud-abuse-laws/
- CMS, Physician Self-Referral Law: https://www.cms.gov/medicare/regulations-guidance/physician-self-referral/current-law-and-regulations
Written by New Century Labs and reviewed for operational accuracy by the New Century Labs team — not reviewed as legal advice. Last reviewed July 2026; laws and payer rules may change. Confirm the right workflow for your practice with your healthcare counsel.
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Next step
Talk through the right cash-pay lab workflow for your practice.
New Century Labs supports multiple billing workflows so clinics and their counsel can choose the structure that fits their state, payer mix, and practice model. Choose your starting point, then confirm it with counsel — we’ll help you compare Direct Pay, Service Fee, and Self-Managed pricing.