Concierge Medicine Specialties: Primary Care, Subspecialties, and Beyond

Where membership care started

Concierge medicine grew out of primary care. When the U.S. Government Accountability Office surveyed concierge physicians using 2004 data, nearly all of them practiced primary care. That is still where most membership practices are found.

The model has since been adopted, in smaller numbers, by specialists and by other licensed clinicians. The American College of Physicians' definition of direct patient contracting practices explicitly includes direct specialty care.

A note on evidence. For primary care membership models, independent research is limited. For specialty memberships, we found almost none. Most available descriptions come from practices and vendors. Read this guide as a map of what is offered, not as evidence of what works.

Primary care specialties

These are the fields in which concierge and direct primary care practices are most common.

Internal medicine

Internists care for adults, with a focus on preventing, diagnosing, and managing adult illness, including chronic conditions, and coordinating care among specialists. Many concierge practices are led by internists.

Family medicine

Family physicians care for patients of all ages, from children to older adults, combining preventive care with treatment of acute and chronic problems. Family physicians run a large share of direct primary care practices.

Pediatrics

Pediatricians care for infants, children, and adolescents. Membership pediatric practices typically emphasize direct access for parents. Fees for children are often lower than adult fees. See membership costs.

Geriatrics

Geriatricians focus on the needs of older adults, such as managing multiple medications, mobility, and memory concerns. Because most of their patients have Medicare, the Medicare rules for concierge care are especially relevant here.

Medical subspecialties

Membership and retainer arrangements are also marketed in a range of specialties. Offerings differ so much that general descriptions are of limited use, but these are the fields you are most likely to encounter.

These are summaries of how practices describe themselves. We have not found independent data on how common each is or on results.

How specialty memberships differ

A few things change when the membership practice is a specialist.

• It does not replace primary care. A cardiology membership covers cardiology. You still need a primary care clinician.
• Procedures and tests are usually separate. The procedures that make up much of specialty care, along with facility fees, are generally billed outside the membership.
• Insurance matters more. Specialty care often involves expensive testing, drugs, and procedures. Confirm how each will be billed and whether the practice is in your network.
• HSA rules differ. The federal rule that made certain memberships compatible with health savings accounts, described in IRS Notice 2026-5, applies to primary care services delivered by primary care practitioners. Do not assume a specialty membership is treated the same way.
• Medicare rules still apply. Medicare does not cover membership fees, and a fee cannot add charges for services Medicare already covers.

Beyond physicians

Membership and cash-based models are also used by other licensed professionals.

Physical therapy

Some physical therapists operate cash-based or membership practices, often built around longer one-on-one sessions. Physical therapy has its own rules, especially for people with Medicare. We cover it in a separate guide: concierge physical therapy.

Other services

You may also see membership pricing for services such as nutrition counseling, health coaching, or executive physicals. Some of these are delivered by licensed clinicians and some are not. Ask who provides the service, what license they hold, and whether any of it is medical care that your insurance would otherwise cover.

Checking a specialist's credentials

The same tools work for any physician.

• DocInfo shows where a physician is licensed and any state board actions.
• Certification Matters shows whether a physician is board certified and in which specialty. For a specialty membership, confirm that certification matches the specialty being advertised.

Questions to ask a specialty membership practice

1. What does the membership cover that an ordinary specialist visit would not?
2. Which procedures, tests, and facility fees are billed separately?
3. Do you bill my insurance or Medicare for visits and procedures?
4. How will you coordinate with my primary care clinician?
5. What are the cancellation and refund terms?

For a fuller list, see questions to ask a concierge doctor.