Fee-for-service
Fee-for-service (FFS) is the payment model where providers bill for each individual service rendered — every visit, test, and procedure coded and reimbursed separately.
- Each service billed separately against CPT codes
- Still the dominant US payment model
- Rewards volume — the core critique VBC answers
- Cash-pay telehealth mirrors FFS without claims
How FFS shapes healthcare
FFS is the default architecture of US healthcare billing: services map to CPT codes, codes map to negotiated rates, and revenue scales with volume. Its virtue is simplicity and its vice is incentive — more services mean more revenue, whether or not outcomes improve, which is the critique that birthed value-based care.
FFS and telehealth programs
Insurance-billed telehealth is FFS with a modifier: each visit becomes a coded claim. Cash-pay programs are FFS in spirit — pay per visit or subscription — without the claims machinery. The design consequence: FFS-style economics reward efficient encounter throughput, which is why async review and clinician utilization are the operational metrics that decide margins.
Compliance handled, so you can build
Lithos runs the clinicians, pharmacies, and 50-state rules behind your care program — one API.
Frequently asked questions
Is cash-pay the same as fee-for-service?
Economically similar — payment per service — but without payers, claims, or negotiated rates.
Why is FFS criticized?
It pays for activity, not results, creating incentives for volume over value — the gap value-based models try to close.
Do payers still use FFS for telehealth?
Yes — most insurance-covered telehealth is reimbursed fee-for-service under standard E/M codes with telehealth modifiers.