A co-payment is a fixed fee an insured person is expected to pay each time a particular covered medical service is received and can differ by the place of service. The American Academy of Family Physicians (AAFP) supports providing a defined set of visits and primary care services to patients without financial barriers, such as co-payments, deductibles and other cost-sharing. This is essential when services are provided by the patient’s usual source of primary care and should apply regardless of the payment model through which the patient is attributed.
The AAFP supports the application of differential co-payments by practice setting only to incentivize patients to select/maintain a usual source of primary care with a medical home as defined by the AAFP.
Patients should not be required to pay more than a single co-payment for services provided during a single encounter whether in-person, virtual or asynchronous.
Physicians are encouraged to understand their payer contracts and applicable laws to identify legal and ethical methods to reduce financial barriers to care imposed by co-payments. Such methods may include sliding fee schedules, payment plans and balance forgiveness after reasonable collection efforts. Physicians should be aware that forgiving or waiving co-payments may not be consistent with the terms of payer contracts, and they should consult with legal counsel or compliance experts to develop appropriate patient-centered financial assistance policies.
(Board Chair October 2006) (April 2025 BOD)