As a private GP, should I charge separately for pathology and tests?
Why most private GPs charge for tests on top of the consultation, how to price them, and what to tell patients first.
The short answer
Yes, most private GPs charge for pathology, ECGs and other tests on top of the consultation fee, because the tests each patient needs vary and each one has real costs. Price each test from its full cost, not just the lab fee, publish your prices and tell the patient what they will pay before you take the sample. Use packages for defined services such as health checks.
Key points
- Charging for tests separately means each patient pays only for what they need.
- Price each test from its full cost: lab fee, consumables, staff time, courier, equipment and result handling.
- Publish a price list and tell patients the cost of tests before you take the sample.
- Order tests for clinical reasons, and be open about any financial interest in a lab or service.
- Packages suit defined services such as health checks. Itemised pricing suits general consultations.
Why most private GPs charge separately
Patients need different tests, and some need none. A single fee that included every possible test would either overcharge most patients or leave you out of pocket when someone needs a full blood panel. Charging for tests as separate items means each patient pays for what they actually have.
In-house tests cost money too. Equipment has to be bought, serviced, calibrated and electrically safety tested, and each test uses consumables and clinic time. That is why many practices charge for:
- phlebotomy (the blood draw) and the laboratory tests themselves
- ECGs, including any external reporting fee
- spirometry
- audiometry
- urine tests beyond a simple dipstick, such as culture sent to the lab
- vaccines, medicines and dressings you supply.
Three ways to price tests
| Model | How it works | Suits |
|---|---|---|
| Itemised | Consultation fee plus a published price for each test or profile | General consultations where tests vary |
| Test fee plus handling | The lab’s price plus a fixed fee for phlebotomy, packaging, courier and reviewing the result | Practices that order many different lab tests |
| Package | One price for a defined set of tests and a results appointment | Health checks, well-person and sexual health screens |
Many practices use a mix: itemised prices for general consultations and packages for screening. See health screening packages.
Setting a price for each test
Charging only what the lab charges you usually means losing money, because the lab fee is not the whole cost. For each test, add up:
- the lab or reporting fee, from your lab’s current price list
- consumables, such as tubes, needles, electrodes and dressings
- clinician or healthcare assistant time to take the sample or do the test
- courier or postage
- equipment costs spread over its life, including servicing and calibration
- your time to review, act on and communicate the result.
Then check your prices against local competitors for common tests. Patients do compare them. If you work under practising privileges, the clinic may set test prices for you.
Your lab’s prices change, so review your test prices when your lab contract is renewed, and at least once a year. See choosing a pathology lab and getting ECGs interpreted.
Telling patients before you test
Being open about cost is a professional duty as well as good business.
- GMC guidance expects you to be clear about how much patients will pay for each investigation or treatment, and when. If you do not know the total, for example because a lab may add tests, say so and explain how they can find out.
- Tell patients if a test would be free on the NHS when you have reason to think they do not know. Some patients will then choose to ask their NHS GP.
- Consumer law expects advertised prices to include any charges the patient cannot avoid. Where the total cannot be worked out in advance, you must explain how it will be calculated.
In practice:
- Publish a price list for common tests on your website, next to your consultation fees.
- Say on your booking page that tests are charged separately, with a link to the list.
- In the consultation, tell the patient the price of the tests you recommend before you take the sample, and record that they agreed.
- Never describe something as “free” if the patient has to pay anything else to receive it.
Keep clinical judgement separate from income
Test income is a real part of many private practices, which creates an obvious risk. Order tests because they will change what you do for the patient, not because they add to the bill. The GMC says you must not let financial interests affect the way you propose, provide or refer. Be open with patients about any financial interest you have, such as owning part of a lab or diagnostic service you use.
Large, untargeted test panels also create work you must take responsibility for: every abnormal result needs acting on, whoever ordered the package.
Collecting payment and VAT
Take payment for tests before the patient leaves, by card or payment link, rather than invoicing later. Itemised invoices also help patients whose cash plan or insurance reimburses some tests. See collecting payment.
Tests done as part of diagnosing or treating a patient share the VAT exemption for medical care, and so do items you administer during treatment. Medicines or goods the patient takes away can be standard-rated. See VAT for private GPs.
For setting the consultation fee itself, see how much to charge.
Frequently asked questions
Should I charge for an ECG done in the consultation?
Most private GPs do, because the machine, its servicing, the electrodes, the time and any external report all cost money. Tell the patient the price before you record it.
Can I add a margin to lab fees?
Yes, as long as your prices are clear and the patient knows them before agreeing. A handling fee that covers phlebotomy, courier and result review is common.
What if the lab adds a test after I send the sample?
Tell patients in advance that reflex tests can happen and how they are charged. If a test adds a cost you did not expect, contact the patient before passing the charge on.
Should the consultation fee include a dipstick?
Many practices include simple point-of-care tests such as a urine dipstick in the consultation fee, and charge only for tests sent to a lab. Whatever you decide, say so on your price list.
