What Are Operating Costs For House Call Doctor Service?
House Call Doctor Service Running Costs
Running a House Call Doctor Service requires substantial fixed and variable capital, with estimated monthly operating costs starting around $136,500 in 2026 This figure includes $63,417 for clinical and administrative payroll, plus $36,700 in fixed overhead like insurance and vehicle leases Variable costs, including medical supplies (45%) and fuel (60%), consume approximately 20% of your $181,917 average monthly revenue in the first year Your primary financial lever is managing provider capacity utilization and keeping variable expenses below 20% The business is projected to hit breakeven quickly-within 1 month-but requires a minimum cash buffer of $832,000 to cover initial capital expenditures and working capital needs
7 Operational Expenses to Run House Call Doctor Service
#
Operating Expense
Expense Category
Description
Min Monthly Amount
Max Monthly Amount
1
Payroll
Clinical and Administrative
This covers the Medical Director, Practice Administrator, and clinical support staff (90 FTEs in 2026).
$63,417
$63,417
2
Malpractice Insurance
Liability
The premium is a major fixed cost critical for mitigating liability across all medical staff and services.
$12,000
$12,000
3
Vehicle Fleet Lease
Logistics
Logistics overhead is fixed monthly for the vehicle fleet lease, essential for provider mobility.
$8,500
$8,500
4
Medical Supplies
Variable
Variable costs for supplies and disposables average 45% of revenue, directly scaling with patient visits.
$0
$0
5
Lab and Diagnostic Fees
Variable
These fees cover outsourced testing and imaging necessary for accurate home-based diagnoses, representing 55% of revenue.
$0
$0
6
Administrative Hub Rent
Fixed Overhead
Office space for coordination and billing is a fixed cost necessary for centralized operations.
$6,500
$6,500
7
EHR and Scheduling Software
Technology
Technology costs for Electronic Health Records (EHR) and scheduling systems are fixed monthly, ensuring compliance and efficiency.
$2,200
$2,200
Total
All Operating Expenses
All Operating Expenses
$92,617
$92,617
What is the total monthly running budget needed for the first 12 months?
The initial 12-month budget for the House Call Doctor Service centers on covering roughly $5,000 in fixed monthly overhead while managing variable costs tied directly to physician compensation and supplies per visit; you defintely need to model this conservative baseline spend first. To understand how to optimize this spend, look into How Increase House Call Doctor Service Profits?
Fixed Overhead Snapshot
Monthly rent for a small administrative hub is estimated at $2,500.
Medical liability and general insurance coverage runs about $1,800 monthly.
Essential software, including Electronic Health Record (EHR) systems, costs $700 per month.
Total fixed overhead before any patient visits is $5,000.
Variable Cost Per Visit Reality
Variable costs per visit total about $175 (physician stipend plus supplies).
If you only achieve 60 visits in month one, variable spend is $10,500.
The total cash burn for that low-volume month hits $15,500 ($5,000 fixed + $10,500 variable).
Focus on physician utilization; low volume means high cost per service delivery.
Which recurring cost category represents the largest percentage of monthly revenue?
For the House Call Doctor Service, payroll will dominate recurring costs, often consuming 60% or more of monthly revenue, making staffing efficiency the critical lever; you can review initial setup costs here: How Much To Start House Call Doctor Service?
Payroll Efficiency Focus
Aim for 100+ billable visits per full-time equivalent (FTE).
Track time spent on admin vs. patient care.
High utilization drives down the cost-per-visit ratio.
Physician cost: ~$180 per visit (60% of $300 AOV).
Vehicle cost: ~$12 per visit (assuming 100 visits/month).
Insurance cost: ~$15 per visit.
Total variable cost is high, so fixed costs must be low.
Vehicle fleet costs and malpractice insurance are secondary, but they are real fixed burdens you carry even if the doctor sees zero patients. A single vehicle lease, fuel, and maintenance might run $1,200 monthly. Malpractice insurance, which protects the practice, could add another $1,500 per provider annually, or $125 monthly per doctor if you spread it out. These costs don't scale down easily when utilization drops, so you need tight control over fleet size and insurance deductibles. It's defintely easier to manage a small fleet than an oversized one.
Fleet Cost Management
Evaluate mileage reimbursement vs. company-owned vehicles.
Fuel efficiency matters more than vehicle luxury.
Use geo-mapping to optimize routing density.
Don't over-allocate vehicles to underutilized staff.
Ensure policy limits match projected revenue exposure.
Higher deductibles lower the premium, but increase risk.
This cost is fixed per provider, not per visit.
How many months of operating expenses must be covered by initial working capital?
You need to know exactly how long your initial funding lasts before the House Call Doctor Service starts paying its own way. Determining this runway is critical for managing investor expectations; for instance, if you are planning your launch, review how to structure the initial setup by reading How To Launch House Call Doctor Service Business? Based on current projections, the minimum cash required to sustain operations before positive cash flow stabilizes and covers debt servicing is $832,000, needed by February 2026. That's a hefty number to cover, so we need to look at what drives it.
Defining Minimum Runway
Target cash buffer is $832,000.
This covers operating expenses until stabilization.
Must be secured before February 2026.
This isn't profit; it's pure operational float.
Hiting Cash Neutrality
Focus on achieving positive cash flow quickly.
Ensure this cash covers all debt servicing needs.
Watch physician utilization rates closely.
If onboarding takes longer, churn risk rises defintely.
If patient volume falls 25% below forecast, how will we cover fixed costs?
If patient volume for the House Call Doctor Service drops 25% below forecast, you must defintely slash non-essential fixed spending, primarily marketing, and check if provider utilization rates remain above the minimum required threshold.
Quick Cost Triage
Review all fixed costs for immediate, temporary reductions.
If volume is low, shift providers to documentation or outreach, not idle waiting.
Key Takeaways
The estimated monthly running cost for a House Call Doctor Service begins around $136,500, driven primarily by high fixed overhead expenses.
Clinical and administrative payroll is the largest single expense category, accounting for $63,417 of the monthly operating budget.
Effective financial management hinges on keeping variable costs, including supplies and fuel, tightly controlled at approximately 20% of monthly revenue.
A significant minimum cash buffer of $832,000 is required to cover initial capital expenditures, even though the service is projected to reach breakeven within one month.
Running Cost 1
: Clinical and Administrative Payroll
2026 Payroll Baseline
Payroll for 90 FTEs in 2026 is projected at $63,417 monthly, establishing a significant fixed cost floor. This covers the Medical Director, Practice Administrator, and all necessary clinical support staff.
Staffing Input Needs
This $63,417 monthly figure requires careful headcount planning across all operational tiers for 2026. You need precise salary bands for the Medical Director and the Practice Administrator, plus the blended average for clinical support staff. This is a major fixed commitment, defintely.
Determine salary per role band
Project 90 FTEs total
Factor in benefits load (not included)
Managing Fixed Labor
Optimize by phasing in clinical support staff based on actual visit volume, not just projected growth targets. Every FTE hired before revenue supports it eats into runway. Ensure the Practice Administrator drives billing cycle efficiency to cover their own cost quickly.
Stagger hiring past 2026 projection
Benchmark support staff ratios
Link raises to utilization metrics
Payroll Risk
This $63,417 fixed payroll requires strong revenue coverage; it's a major drain if utilization lags. You must secure enough fee-for-service revenue to cover 90 salaries before funding variable costs like supplies.
Running Cost 2
: Malpractice Insurance
Insurance Fixed Burden
Malpractice insurance is a non-negotiable fixed overhead for your house call service, costing $12,000 monthly. This premium directly covers liability exposure for every physician and service provided, acting as a crucial safety net. Because it doesn't scale with visits, managing order density is key to absorbing this high base cost efficiently.
Cost Inputs
This $12,000 monthly charge covers professional liability for every physician delivering care. You need quotes based on physician count and service scope to set this premium. It's a substantial fixed cost, representing nearly 19% of your total monthly fixed operating expenses, excluding supplies that scale with revenue.
Cost is fixed at $12,000 per month.
Covers all medical staff liability.
Essential for service compliance.
Managing Exposure
You can't really lower this without cutting staff, but you manage the risk exposure actively. Avoid common mistakes like underinsuring staff or using outdated policy limits. Shop carriers annually to benchmark rates; sometimes switching providers after a clean claims history yields minor savings, defintely under 5%.
Benchmark rates every renewal cycle.
Ensure limits match physician caseloads.
Never skimp on coverage quality.
Leverage Point
Since this $12,000 premium is fixed, your operational leverage depends entirely on visit density. If you only achieve 50% of your projected caseload, this insurance cost hits your contribution margin hard. You need high utilization fast to spread this overhead across enough billable home visits.
Running Cost 3
: Vehicle Fleet Lease
Fixed Fleet Cost
The $8,500 monthly fleet lease is a non-negotiable fixed cost underpinning provider mobility for every home visit. Since this cost is independent of patient volume, profitability hinges on maximizing route density immediately after launch. This cost must be covered before variable costs are considered.
Lease Inputs
This $8,500 covers the core logistics overhead for the provider fleet, ensuring mobility for service delivery. To budget accurately, you need the exact monthly lease payment for the required number of vehicles, plus any initial deposits or insurance riders factored in. This is a foundational fixed expense, sitting above payroll but below clinical supplies in the cost stack.
Monthly lease payment amount.
Required vehicle count.
Insurance/registration add-ons.
Fleet Efficiency
Since this is fixed, you manage it by optimizing utilization, not cutting the payment itself. Avoid over-leasing vehicles early on; match the fleet size precisely to the 90 FTEs projected payroll in 2026. A common mistake is leasing luxury models when reliable economy vehicles suffice for local travel.
Match vehicle count to active providers.
Negotiate mileage caps upfront.
Centralize vehicle assignment.
Mobility Anchor
This $8,500 is a hard anchor for your break-even calculation; if provider caseloads don't materialize fast enough, this fixed cost will quickly erode working capital. Remember, this cost exists whether you complete zero visits or one hundred.
Running Cost 4
: Medical Supplies
Supply Cost Reality
Supplies and disposables are a 45% variable cost tied directly to patient volume and complexity. This scales immediately with every house call you make. Managing inventory is crucial because this cost eats revenue fast. You defintely need tight control here.
Input Needs for 45%
This 45% figure includes disposables like gauze, needles, and basic diagnostic strips used per patient encounter. Estimate this by tracking the average supply spend per procedure code or visit type. If your average revenue per visit is $200, expect $90 in supply costs per visit before factoring in fixed overhead.
Track usage per procedure.
Benchmark against similar practices.
Factor in complexity adjustments.
Controlling Usage
Since this cost scales with volume, focus on procurement efficiency, not volume reduction. Negotiate tiered pricing with your primary medical distributor based on projected annual spend. Avoid keeping excess inventory of expensive, single-use items; that ties up cash and increases obsolescence risk.
Centralize purchasing decisions.
Implement usage tracking per provider.
Review vendor contracts quarterly.
Margin Check
Supplies at 45% plus lab fees at 55% means 100% of your revenue is consumed by variable costs before fixed overhead even starts. Your contribution margin is zero until you reduce these two inputs or raise your visit fee above the cost of service delivery.
Running Cost 5
: Lab and Diagnostic Fees
Diagnostic Cost Hit
Lab and diagnostic fees are your biggest variable expense, eating up 55% of revenue. This covers all outsourced testing and imaging required for accurate diagnoses during home visits. Managing this cost is critical since it scales directly with every service rendered. Honestly, this percentage dictates your entire gross margin structure.
Calculating Testing Spend
This 55% expense covers external lab work like blood draws or specialized imaging ordered during a house call. To model this accurately, you need the average cost per test multiplied by the expected tests per visit. Since it's a percentage of revenue, it dwarfs the 45% average variable medical supplies cost. Here's the quick math:
Tests per visit (e.g., 1.5)
Average outsourced test price
Controlling Outsourced Tests
Reducing this high percentage requires strict protocols on when external testing is ordered versus when a physician can diagnose without it. Negotiate volume discounts with your primary lab partner now. Avoid unnecessary 'just in case' testing to keep quality high but costs down; this is defintely achievable with good physician oversight.
Standardize diagnostic pathways.
Negotiate tiered pricing contracts.
Review physician ordering habits quarterly.
Margin Check
Because diagnostics are 55% of revenue, your gross margin relies heavily on visit pricing covering this plus the 45% supply cost. If your average revenue per visit doesn't support this 100% variable load, you have zero margin before fixed overhead like the $63,417 payroll even starts.
Running Cost 6
: Administrative Hub Rent
Fixed Hub Cost
Centralized office space for billing and coordination costs a fixed $6,500 per month. This hub supports all administrative functions required to manage patient scheduling and process fee-for-service revenue streams effectively. You can't run this operation without this baseline overhead.
Cost Inputs
This $6,500 monthly rent is a fixed overhead supporting non-clinical staff handling patient intake and claims. It's separate from the $63,417 payroll for clinical staff. You need this space before you can process the first visit.
Fixed monthly overhead amount.
Covers billing and coordination.
Essential for centralized ops.
Management Tactics
Since this is fixed, cutting it means moving to a smaller space or going fully remote for admin staff. If you scale quickly past 100 visits/day, the cost per visit drops fast. Don't sign a lease longer than 24 months initially.
Negotiate shorter lease terms.
Test partial remote admin work.
Avoid premium downtown locations.
Break-Even Context
This $6,500 must be covered by patient visits before you see profit. If your average revenue per visit is $250, you need about 26 visits monthly just to pay the rent. That's very low, but it's the first hurdle.
Running Cost 7
: EHR and Scheduling Software
Tech Cost Baseline
Your required technology spend for Electronic Health Records (EHR) and scheduling software is a predictable fixed cost of $2,200 per month. This budget item is non-negotiable because it secures patient data compliance and streamlines provider workflow across your house call operations. This cost must be covered before hitting profitability.
Budgeting the Tech Stack
This $2,200 monthly fee covers the necessary software infrastructure for managing patient charts and booking provider routes for your service. Since it is fixed, it acts like overhead, similar to the $6,500 rent for the administrative hub. You must budget this cost every month, regardless of how many house calls your 90 FTEs complete.
Fixed monthly subscription fee.
Covers HIPAA compliance tools.
Essential for scheduling physician caseloads.
Controlling Software Spend
Managing this cost means resisting feature creep; don't pay for modules you won't use immediately. Since this cost is fixed, savings come from negotiating annual contracts instead of month-to-month billing, which can sometimes shave 10% to 15% off the total. Avoid cheap, non-compliant systems, as regulatory fines defintely dwarf software savings.
Negotiate multi-year deals upfront.
Audit user seats quarterly.
Prioritize core scheduling functions only.
Break-Even Impact
This $2,200 software cost directly impacts your required visit volume to cover fixed overhead. If your total fixed costs are around $27,200 (including payroll, rent, and insurance), the software is a predictable component you must cover daily through patient visits before generating profit. It's a baseline operational necessity.
