Good faith exam coverage costs one of two ways: a per-encounter fee from a third-party vendor, or a flat monthly rate bundled into physician oversight. The per-encounter fee looks cheaper for a small clinic, but it climbs with every new patient and renewal, and it rarely includes a delegation agreement, chart review, or physician access. A flat rate covers all of that for one price, so it usually costs less once a practice crosses a certain volume. The right choice comes down to your patient volume and what the fee actually includes, not just the number on the invoice.

Per-Encounter Pricing Models

Most online good faith exam vendors charge per good faith exam rather than per patient relationship, with fees running from about $27 to $40 per encounter. Clinics that handle good faith exams in-house instead charge patients a comparable $30 to $45 flat fee at the front desk. That per-exam rate compounds quickly once volume, renewal frequency, and state telehealth rules come into play.

• Volume cost: A med spa processing 200 exams a month at $35 each pays roughly $7,000 a year for exam access alone.
• Renewal frequency: Most states treat annual renewal as the baseline for aesthetic treatments, but GLP-1 and other weight-loss prescribing often requires renewal every six months, which doubles the exam cycles a clinic pays for.
• Telehealth variance: California permits some asynchronous exam elements under strict documentation conditions, while Texas and Florida allow telehealth exams but attach specific delegation and prescribing-authority requirements.
• Standing-order risk: Arkansas has flagged virtual exams built on standing orders rather than individualized clinical judgment as falling short of board expectations.

A per-encounter fee also excludes the paperwork a board actually checks during an audit: a signed delegation or protocol agreement, chart review, and a physician who is reachable if a patient has a reaction. Those pieces get billed separately or dropped entirely, which is why the per-exam rate rarely reflects the full cost of staying compliant.

Flat-Rate Physician Oversight Models

A flat monthly rate bundles good faith exam coverage into a broader physician oversight arrangement instead of billing per encounter. One fee covers good faith exam access, a signed delegation or protocol agreement, chart review, and physician availability. Physician oversight is defined by how each state regulates delegation, not by the exam alone.

• California: The Corporate Practice of Medicine doctrine restricts non-physician ownership and ties patient evaluation to an “appropriate prior examination” standard rather than the term good faith exam.
• Texas: The state uses a delegation model under its Occupations Code, requiring the physician to specifically authorize each procedure and medication category an advanced practice provider performs.
• Florida: Physician protocols apply a more prescriptive pairing between the good faith exam and prescribing authority.
• Arizona: Full practice authority for nurse practitioners in many aesthetic settings changes who needs to hold the oversight relationship at all.

The same flat rate can carry a different agreement depending on where the practice operates, since the delegation language has to match the state’s rule. A practice operating in more than one of these states needs an oversight agreement written for each one, not a single contract applied across all of them.

Why the Cheapest Option Can Cost More Later

The lowest per-exam price usually comes from a vendor that disclaims responsibility for establishing a genuine patient-provider relationship in its own contract. That disclaimer doesn’t transfer to your practice. If a patient is harmed, the board complaint or malpractice claim names your physician and your clinic, not the vendor.

• Kentucky and Arkansas: Both state nursing boards have issued guidance requiring independent clinical judgment from a licensed provider, not a signature applied to pre-collected intake data.
• Louisiana: Practices must confirm the same standard with their own nursing and medical boards, since delegation rules are set at the state level and don’t carry over from a neighboring state’s guidance.
• Arkansas update: In January 2025, the Arkansas Nursing Board clarified that the term “good faith exam” doesn’t appear in its Nurse Practice Act and raised concerns about virtual exams that skip proper follow-up.
• Volume incentive: A vendor charging the lowest per-exam rate has a financial incentive to move fast through each encounter, which is the exact pattern regulators are watching for.

Insurers have denied malpractice claims outright when the good faith exam record didn’t show a valid patient-provider relationship, leaving the practice to cover the payout itself. Buyers evaluating a practice for acquisition also flag thin good faith exam records during due diligence, which lowers the sale price or kills the deal.

What’s Actually Included at Each Price Point

A per-encounter fee buys good faith exam access and a documentation record for that single visit. A flat-rate oversight arrangement is priced to include four additional components a per-exam fee typically leaves out. The American Med Spa Association has flagged the gaps below as a common compliance failure found in med spa investigations.

• Delegation or protocol agreement: A document matched to the state’s specific rules, not included in a per-encounter fee.
• Chart review: Ongoing review of patient records across the practice, not just the single good faith exam visit.
• Physician availability: Contractual access to a physician for consultation between exams.
• Named physician of record: A physician who carries documented responsibility for the practice’s clinical decisions, which is what a board asks for during an audit.

A per-encounter fee covers the good faith exam and nothing else, so a practice paying only that rate is missing the paperwork that actually gets checked during a compliance review. The flat-rate price includes that paperwork by design, which is why the two models aren’t a fair apples-to-apples comparison on cost alone.

How Medical Director Co. Prices This: $799 a Month, All-In

Medical Director Co. bundles good faith exam coverage into a flat rate of $799 a month. There’s no setup fee and no per-encounter charge that climbs with patient volume. The rate includes an attorney-reviewed physician agreement built for the state where your practice operates, ongoing chart review, and continuing access to your assigned physician for clinical questions. The agreement is also structured around the delegation, telehealth, and renewal rules that actually apply to your location.