NEWCENTURYLABSEST. 2014

Can California Clinics Offer Cash-Pay Labs?

California caps what a clinic may charge for an outside lab’s test at what the lab charged (B&P §655.5) — Direct Pay or a disclosed Service Fee; markup is not permitted.

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

Can California clinics offer cash-pay labs? Yes, but California law caps what you can charge at the lab’s own price. No markup. Use Direct Pay or pass the lab charge through at cost, and bill your clinic’s own services separately.

Three billing workflows

Direct Pay, Service Fee, and Self-Managed Pricing

Simplest starting point

Direct Pay

Patient pays New Century Labs directly for lab testing.

PatientNew Century Labs

Where it fits
Stricter states, Medicare-sensitive workflows, or clinics that want no rebilling burden.
Keep in mind
The clinic never touches the lab bill — New Century Labs bills the patient.
For real clinic work

Service Fee

Clinic may charge a transparent fee for professional/admin services.

PatientNew Century Labs + Clinic fee

Where it fits
Clinics that provide consultation, interpretation, specimen coordination, or care planning.
Keep in mind
Keep the fee tied to services the clinic actually performs.
Requires review

Self-Managed Pricing

Clinic controls patient pricing where state law and payer context allow.

PatientClinicNew Century Labs

Where it fits
Practices in permissive states with counsel-approved billing policies.
Keep in mind
Review with counsel — it may not fit every state or payer context.

Calculator

What would your California patients pay?

Compare patient-direct billing, optional service fees, and practice-managed pricing using your own test mix.

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California caps what a clinic may charge for an outside lab’s test at the lab’s own price (B&P §655.5). Start with Direct Pay, where the patient pays New Century Labs directly, and add a disclosed Service Fee for your clinic’s own work.

Recommended starting point for California clinics

Start with Direct Pay. If you rebill, pass the lab charge through at cost. Your margin comes from a Service Fee for your own work, never from the lab test.

California-specific billing considerations

California bars marking up outside lab work, and requires the lab to bill directly for lab services. Use Direct Pay, or pass the lab charge through at cost. Charge for your own services separately. For reference, see California’s statute, Cal. Bus. & Prof. Code § 655.5.

How each workflow fits in California

WorkflowFit for California clinics
Direct PayRecommended, or pass the lab charge through at cost.
Service FeeFine for the clinic’s own separate work; no profit on the lab service.
Self-ManagedNot permitted: California caps the charge at the lab’s own price.

Medicare-sensitive workflows

In California, Medicare patients usually mean Direct Pay with any clinic fee separate and documented. 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 — see our Medicare guide.

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 questions

Can California clinics offer cash-pay lab testing?

Yes. The real question is which billing workflow, not whether. Most clinics start with Direct Pay: the patient pays the lab directly.

Can a California clinic charge patients more than the lab’s price?

No. California law caps your charge at what the lab charged. Bill your own services separately.

What’s the simplest way for a California clinic to start?

Direct Pay. The patient pays New Century Labs directly and there is nothing to set up. Add a separate service fee for your own work where appropriate.

Sources & review notes

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.

Next step

Talk through the right cash-pay lab workflow for your practice.

Pick the workflow that fits your state and your practice. We’ll help you compare Direct Pay, Service Fee, and Self-Managed Pricing, then confirm it with counsel.