Setting a consultation fee is one of the most important financial decisions for anyone who runs a private practice—and, at the same time, one of the decisions that creates the most uncertainty for physicians. Clinical training does not include pricing, and the result shows up often: fees set by copying colleagues, with no basis in real costs, that barely cover practice expenses or sit far below the professional’s potential. This guide explains how to calculate consultation fees in a structured way, what strategies are available, what the regulations say, and which common mistakes hurt profitability for physicians who see private-pay patients.

Why pricing matters for practice sustainability

Pricing medical consultations properly is what ensures a practice is financially sustainable in the medium and long term—not just in its opening month. A fee below what is necessary may seem strategic for attracting patients at the beginning, but it erodes margins over time and forces the physician to increase patient volume to compensate, compromising both clinical quality and the professional’s quality of life.

The market landscape reinforces the urgency of this topic. Medical Demographics in Brazil 2025, published by FMUSP in partnership with the CFM and Brazil’s Ministry of Health, reports that Brazil now has more than 635,000 active physicians, with a density of almost 3 per 1,000 inhabitants. In major urban centers, competition for private-pay patients is growing, which makes pricing a market-positioning decision—not only a matter of covering costs.

What the regulations say: CFM and the AMB fee schedule

In Brazil, there is no legal minimum fee set for private medical consultations. What exists is a prohibition by the Federal Council of Medicine (CFM) against dishonorable fees—that is, prices so low they devalue the profession and harm colleagues—as stated in the Medical Code of Ethics (CFM Resolution No. 2,336/2023). The code does not define a number, but it establishes that physicians may not engage in unfair competition with colleagues through artificially low prices.

The most widely used market reference is the Medical Fee Schedule from the Brazilian Medical Association (AMB), which presents suggested amounts by procedure and specialty. It is not mandatory for private consultations, but it serves as a broadly recognized market benchmark and is often used in negotiations with health plan operators as a calculation basis for leaving networks or renegotiating contracts.

Methods for calculating a medical consultation fee

There are three main approaches to setting a consultation fee, and the strongest method combines all three. Using only one tends to produce prices that either fail to cover real costs or ignore market positioning.

• Cost-based method (break-even pricing)
  Add up all of the practice’s monthly fixed costs (rent, staff, equipment, systems, accounting, consumables) and divide by the number of consultations performed in the month. Add the desired profit margin, taxes on revenue, and a 15% to 20% reserve for unused appointment slots and nonpayment. The result is the minimum sustainable price.
• Market-based method (benchmark pricing)
  Research the fees charged by professionals in the same specialty in the same city or neighborhood, considering the target audience, location, and level of sophistication of the practice. The AMB fee schedule and informal research with colleagues and medical associations are the most accessible sources for this benchmark.
• Perceived-value method (positioning-based pricing)
  This considers how much value the patient perceives in the care experience: consultation length, practice environment, the professional’s reputation, specialization, easy access, and overall patient experience. Professionals with clear differentiation can charge above-market fees without losing patients.

In practice, the recommended flow is: calculate the break-even point using the cost-based method to define your floor, research the market to understand the ceiling in your specialty and location, and position your fee within that range according to the experience, specialization, and differentiation you offer.

Factors that influence the fee charged per consultation

A consultation fee is not defined only by the practice’s costs. A series of market and professional-positioning variables directly affects what can be charged sustainably.

• Medical specialty
  Specialties with a smaller supply of professionals or greater technical complexity tend to charge higher fees. Neurosurgery, dermatology, and ophthalmology, for example, have historically charged above the average for general practice.
• Geographic location
  Practices in higher-income areas or in capitals with a stronger market for the specialty can charge higher amounts. Location within the city also matters: affluent neighborhoods allow for a higher ticket than outlying areas for the same specialty profile.
• Consultation length
  Longer consultations have a higher opportunity cost for the professional and tend to be perceived as more valuable by the patient. A 45-minute visit should rarely cost the same as a 15-minute visit, even within the same specialty.
• Professional reputation and authority
  Specialist credentials, publications, a relevant digital presence, participation in conferences, and referrals from colleagues build a perception of authority that makes it possible to charge above-average fees without patients questioning the value.
• The professional’s tax structure
  Physicians who operate through a legal entity in Brazil generally have a lower tax burden on revenue, which directly affects the amount that must be charged to reach the same net income as someone operating as an individual taxpayer.

How and when to adjust fees

Adjusting a consultation fee is necessary and legitimate, but it requires planning so it does not create friction with the patient base you have built. The main trigger for review is accumulated inflation: fees that have not been adjusted for more than a year lose real purchasing power, reducing the practice’s margin even if appointment volume remains stable.

The index most commonly used as a reference for adjusting medical fees in Brazil is the IPCA, Brazil’s official inflation index, measured by IBGE (the Brazilian Institute of Geography and Statistics). Annual adjustments equal to the accumulated IPCA are considered neutral from the patient’s point of view and sustainable from the practice’s financial perspective. Adjustments above the IPCA may be justified when there is an expansion of infrastructure, additional staff hiring, equipment acquisition, or a deliberate market repositioning.

• Communicate in advance and clearly
  Inform recurring patients about the adjustment at least 30 days in advance, directly and without excessive explanations. A simple message through the usual communication channel is enough in most cases.
• Prefer small, frequent adjustments over large, infrequent increases
  An annual adjustment of 5% to 8% is much easier for patients to absorb than a 25% increase after three years with no change. Regularity also protects the practice’s margin continuously.
• Maintain consistency across channels
  Update the fee at every point of contact: website, social media, scheduling platforms, and front desk. Inconsistencies create distrust and increase friction at the time of payment.

Teleconsultation pricing: is it different?

A teleconsultation has a different cost profile from an in-person visit, which creates room for distinct pricing strategies. Without costs related to renting a physical exam room, in-person reception, and some consumable supplies, the operating cost per visit tends to be lower. On the other hand, the clinical time and expertise involved are identical to an in-person consultation.

Telemedicine regulation in Brazil was consolidated by Law No. 14,510/2022, which established teleconsultations as a permanent modality equivalent to in-person consultations for clinical and ethical validity. This reinforces that charging less for a teleconsultation is not an obligation: it is a positioning decision. Many physicians choose to charge the same amount to reinforce that the service has the same quality level, regardless of the channel.

The most common mistakes in medical consultation pricing

Most pricing problems in medical practices do not come from bad intentions, but from a lack of method. These are the most frequent mistakes and what each one costs in practice.

• Pricing by imitation, without calculating your own costs
  Copying a colleague’s fee ignores real differences in structure, appointment volume, tax regime, and desired margin. Two practices in the same specialty and neighborhood can have completely different break-even points.
• Not including taxes in the price calculation
  Many physicians set the consultation fee based on what they expect to receive, without calculating how much of the charged amount goes to taxes. Depending on the tax regime, between 13% and 27.5% of incoming revenue never reaches the professional’s pocket.
• Ignoring unused appointment slots in the calculation
  Calculating the price while assuming a 100% full schedule is a classic mistake. Cancellations, rescheduling, and empty slots are inevitable. A practice with 30% idle capacity needs to charge more per consultation than a fully booked practice to achieve the same net margin.
• Going years without adjusting fees
  Fees frozen in nominal terms represent a real drop in revenue over time. A fee that is not adjusted for three years loses between 15% and 25% of its real purchasing power, depending on inflation during the period.
• Confusing revenue with compensation
  What the practice bills is not what the physician receives. Deducting fixed costs, taxes, staff payroll or owner’s draw equivalents, and working-capital reserves before calculating net compensation is the only way to know whether the business is truly profitable.
• Being afraid to charge the right amount
  Underpricing out of fear of losing patients is one of the most common and most costly patterns. Patients who value the care rarely leave a physician because of a reasonable, well-communicated adjustment. Those who leave over price often were not the practice’s target patients in the first place.

Frequently asked questions

Direct answers to the most common questions about medical consultation pricing.