Top 7 States for Concierge Medicine and DPC in 2026

Introduction & Methodology

States were ranked by the total number of MD and DO led concierge and direct primary care practices listed in the NextMD directory as of June 2026.

Each state is ranked simply by the number of practices that exist within that state. NextMD is the largest database of concierge and DPC doctors in the United States. For sake of clarity we only include practices that are led by a medical doctor with either an MD or DO.

We also included the average monthly fee. It is worth noting that only 53% of practices publicly disclose their monthly fee. Additionally, the higher the price the practice, the less likely they are to disclose their monthly fee. The two main styles of practice we talk about are DPC and Concierge medicine, however it is worth noting that a combination of hybrid, performance and speciality practices make up less than 20% of the market that we do not discuss. However these numbers are included in our statewide counts.

The 2026 Ranking at a Glance

All practice counts, fees, physician counts, and model-mix figures below come from NextMD directory data as of June 2026.[1]

1. Florida: 699 Practices

• Practices: 699 (11% of the US total), spread across 147 cities and towns

• Density: 3.1 practices per 100,000 residents, the highest of the top 7

• Average monthly fee: $198 (median $182)

• Model mix: 68% concierge, 21% DPC

• MD/DO physicians listed: 916

Florida is where modern concierge medicine grew up. MDVIP, the largest concierge medicine network in the country, was founded in 2000[3] and still runs its network of more than 1,400 affiliated physicians[4] from its headquarters in Boca Raton.[5]

Four geographies do most of the work. The Naples corridor on the Gulf coast holds 58 practices, the Palm Beach corridor holds 52 in Boca Raton plus 21 in West Palm Beach, Tampa holds 32 including Griffin Concierge Medical with nine physicians, and Orlando and Miami hold 22 each. Retirees and seasonal residents keep demand high year-round, and the law keeps supply growing: Florida Statute 624.27, passed in 2018, defines direct primary care agreements as outside the state insurance code.[6]

2. California: 651 Practices

• Practices: 651 (11% of the US total), in 185 cities, more than any other state

• Density: 1.7 practices per 100,000 residents

• Average monthly fee: $247 (median $200), the highest average of the top 7

• Model mix: 72% concierge, 15% DPC, the most concierge-heavy mix on this list

• MD/DO physicians listed: 983, more than any other state

California lists fewer practices than Florida but more physicians, a sign that its practices skew toward larger groups. Three regional engines drive the market: the Los Angeles wealth corridor led by Beverly Hills (32 practices), the Bay Area tech cluster led by San Francisco (31), and coastal Orange County led by Newport Beach (31).

Pricing here spans the widest range in the country, from $12 a month at the most affordable DPC memberships to $2,000 a month at the ultra-premium end. California also hosts the nation's largest cluster of performance and longevity medicine practices (19), concentrated in Newport Beach, Los Angeles, and the Bay Area. One caveat for DPC shoppers: California has no DPC-specific statute, so direct primary care operates without the legal carve-out that Florida and Texas provide.[7]

3. Texas: 571 Practices

• Practices: 571 (9% of the US total)

• Density: 1.9 practices per 100,000 residents

• Average monthly fee: $166 (median $150)

• Model mix: 55% concierge, 33% DPC, with 187 DPC practices, the most of any state

• MD/DO physicians listed: 776

Texas is the direct primary care capital of America. Its 187 DPC practices beat Florida's 145 and reflect a head start in law: Texas codified DPC as outside insurance regulation in 2015, among the earliest states to do so, and the protection now lives in Chapter 117 of the Texas Occupations Code.[8]

Houston leads every city in the state with 74 practices, followed by Austin (54), Dallas (53), and San Antonio (49). The Interstate 35 corridor from Austin through New Braunfels to San Antonio packs more than 110 practices into roughly 80 miles, the densest DPC geography in the country. Suburban groups like Sweetwater Medical Associates in Sugar Land, with three physicians, are typical of the family-oriented practices that thrive here. No state income tax and a deep bench of corporate headquarters keep both patients and physicians arriving.

4. New York: 361 Practices

• Practices: 361 (6% of the US total)

• Density: 1.8 practices per 100,000 residents

• Average monthly fee: $212 (median $190)

• Model mix: 73% concierge, 12% DPC, the lowest DPC share of the top 7

• MD/DO physicians listed: 566

New York is the most concentrated market on this list. Manhattan alone holds 152 practices and, together with Brooklyn, accounts for about half the state's total. Two things make the market unusual. First, it has the highest share of specialty concierge practices of any top-7 state (8%), with concierge cardiology, concierge pediatrics, and concierge endocrinology available at a density no other US metro supports. Second, Manhattan's major academic medical centers operate their own membership-based concierge programs, a hospital-affiliated format that barely exists in Florida or Texas.

The DPC shortfall has a legal explanation: New York has no DPC statute, and retainer models face more regulatory friction from the state's Department of Financial Services than they would in Texas or Florida.[7] Upstate remains thin, with Rochester at 12 practices and Buffalo and Albany barely represented, so most of the state's growth still runs through the five boroughs and Long Island.

5. Georgia: 207 Practices

• Practices: 207 (3% of the US total)

• Density: 1.9 practices per 100,000 residents

• Average monthly fee: $158 (median $175)

• Model mix: 53% concierge, 34% DPC, the highest DPC share of the top 7

• MD/DO physicians listed: 272

Georgia is an Atlanta story with a strong DPC accent. Greater Atlanta accounts for roughly four in ten of the state's practices, led by Atlanta proper (47), Marietta (16), and Alpharetta (12). Affordable DPC is the signature: practices like Bianco Primary Care in Alpharetta charge $80 a month with three physicians on staff.

Georgia's Senate Bill 18, the Direct Primary Care Act of 2019, exempts DPC agreements from insurance regulation and helped push the state's DPC share to 34%, the highest proportion among these seven states.[9] Outside Atlanta, Savannah is the quiet standout: 16 practices in a city of about 150,000 residents, the highest per-capita concentration in Georgia.

6. Pennsylvania: 196 Practices

• Practices: 196 (3% of the US total), spread across 88 cities and towns

• Density: 1.5 practices per 100,000 residents

• Average monthly fee: $171 (median $179)

• Model mix: 62% concierge, 28% DPC

• MD/DO physicians listed: 281

Pennsylvania is the most decentralized market in the top 7. Philadelphia, its largest city, holds just 21 practices, about one in nine statewide. The real concierge geography is the Main Line, the affluent suburban corridor west of Philadelphia, where Paoli (13), Bryn Mawr (7), King of Prussia (6), and Wynnewood (6) combine for roughly 30 practices along a single commuter rail line. Bryn Mawr Personalized Primary Care, a four-physician concierge group charging $225 a month, sits at the center of that corridor.

Pennsylvania has no DPC-specific statute, which makes its 28% DPC share notable; operators structure memberships carefully to stay clear of insurance regulation.[7] Pittsburgh, with 7 practices for a metro of more than two million people, is the most under-supplied big city on this list.

7. Virginia: 190 Practices

• Practices: 190 (3% of the US total)

• Density: 2.2 practices per 100,000 residents, second only to Florida in the top 7

• Average monthly fee: $154 (median $150), the lowest average of the top 7

• Model mix: 57% concierge, 31% DPC

• MD/DO physicians listed: 315

Virginia earns its spot on density and price rather than raw size. The market splits into two clusters. Northern Virginia, the suburban corridor serving Washington DC, combines Fairfax (17), Alexandria (13), and Arlington (10) and caters heavily to federal executives, contractors, and military families. The Richmond corridor pairs Midlothian (16) with Richmond proper (11), where PartnerMD, a concierge network headquartered in Richmond, anchors the local market at $300 a month.

Virginia's 2017 direct primary care law, codified in Article 10 of Title 54.1 of the Code of Virginia, requires plain-language agreements and keeps DPC outside insurance regulation, and the state's 31% DPC share reflects it.[10] For patients, Virginia is arguably the best value on this list: the second-highest practice density in the top 7 at the lowest average price.

What the Top 7 Have in Common

They concentrate around wealth. None of these are statewide markets. Each one runs through a short list of affluent metros and corridors — Florida's Gulf and Palm Beach coasts, California's Los Angeles, Bay Area, and Orange County, Manhattan, Atlanta's northern suburbs, Philadelphia's Main Line, the Washington DC suburbs of Northern Virginia. Step outside those pockets and even the leading states thin out fast: Pittsburgh has very few practices for a metro of more than two million, in the same state as the Main Line's 30-plus. Membership medicine follows disposable income, and it rarely strays far from it.

Where homes cost more, so does the doctor. Concierge and DPC physicians price to what their local market will bear, so the map of membership fees follows the map of home values. The two most expensive housing states are the two most expensive states for membership care, in the same order California first, New York second and the cheaper-housing states cluster toward the lower-fee end.

It is a tendency, not a rule, and Virginia is the exception that shows why. Its statewide home values are lifted by the wealthy Washington DC suburbs, but its membership fees stay the lowest of the seven because so much of the state runs on lower-cost direct primary care. The DPC statutes that four of these states carry don't override the pattern either: they sit in the more affordable markets rather than create them. Florida has a statute and still posts the third-highest fees; Pennsylvania has none and still runs a 28% DPC share. The through-line is local wealth, not the legal code.

What patients buy is the same everywhere. Whatever the price, the product underneath is similar across all seven states: a doctor with a smaller panel and the time to use it. A Society of Actuaries study found DPC patients visited the emergency room 40.51% less often and had 12.64% lower total care costs than comparable insured patients.[11] Demand for that runs through every market on this list. What the leading states have that others don't is the concentration of wealth to pay for it at scale.

FAQ

Which US state has the most concierge medicine practices?

Florida has the most concierge and DPC practices of any US state, with 699 listed on NextMD as of June 2026. California is second with 651 and Texas third with 571. Florida also has the highest practice density of any large state, at 3.1 practices per 100,000 residents.[1]

Which state has the most direct primary care (DPC) practices?

Texas leads in absolute numbers with 187 DPC practices, ahead of Florida's 145. Georgia has the highest DPC share among the top states, at 34% of its 207 practices. Both states have laws that exempt DPC agreements from insurance regulation.[1]

How much does concierge medicine cost in the top states?

Among practices that publish pricing, average monthly fees in the top 7 states range from $154 in Virginia to $247 in California, against a national average of $174 a month.[1] Across all models, DPC memberships typically run $50 to $200 a month, while concierge medicine runs $3,000 to over $40,000 a year. See our full guide to how much concierge medicine costs.

Which states have laws protecting direct primary care?

Roughly half of US states have passed laws exempting DPC agreements from insurance regulation.[7] Among the top 7 concierge states, Texas (2015), Virginia (2017), Florida (2018), and Georgia (2019) all have DPC statutes. California, New York, and Pennsylvania do not, which is one reason their markets skew toward concierge rather than DPC.

What is the difference between concierge medicine and DPC?

Concierge medicine typically charges a higher annual retainer and may still bill insurance for visits, while DPC charges a flat monthly fee that covers most primary care without insurance billing. Both models offer smaller patient panels, longer visits, and direct physician access. For a full breakdown, see our concierge medicine versus direct primary care comparison.

Which states are next in line behind the top 7?

North Carolina (185 practices), Colorado (178), Illinois (171), and Arizona (170) sit just behind the top 7. North Carolina is notable as the only near-miss state where DPC practices outnumber concierge practices.[1]

NextMD lists 6,185 physician-led concierge and DPC practices across all 50 states. Compare pricing, panel sizes, and doctor credentials, and filter by state, city, and model type at nextmd.ai/search.

Sources

1. NextMD. (2026). NextMD practice census. Directory data across 6,185 MD/DO-led concierge and DPC practices and 8,744 physicians in more than 1,900 US cities (June 2026 refresh).

2. US Census Bureau. (2024). State Population Totals and Components of Change: 2020-2024. State population estimates tables

3. Charlesbank Capital Partners. MDVIP investment profile. MDVIP was founded in 2000 and is the largest provider of membership-based healthcare in the United States. MDVIP at charlesbank.com

4. MDVIP. (2026). About MDVIP. Network of more than 1,400 affiliated physicians nationwide. About MDVIP

5. MDVIP. (2026). MDVIP Celebrates 100 Consecutive Quarters of Growth and New Boca Raton HQ. MDVIP press room

6. Florida Legislature. (2018). Section 624.27, Florida Statutes: Direct Primary Care Agreements. A direct primary care agreement does not constitute insurance and is not subject to the Florida Insurance Code. Fla. Stat. 624.27 (2018)

7. DPC Frontier. (2026). State "Defining Outside of Insurance" Laws. State-by-state tracker of direct primary care legislation. DPC Frontier state law tracker

8. DPC Frontier. (2026). Texas. Texas direct primary care law summary, including the 2015 codification and current Occupations Code placement. DPC Frontier: Texas

9. Georgia General Assembly. (2019). Senate Bill 18: The Direct Primary Care Act. Direct primary care agreements are not insurance and are exempt from regulation as insurance. SB 18 signed legislation (PDF)

10. Code of Virginia. Title 54.1, Chapter 29, Article 10: Direct Primary Care Agreements. Va. Code Article 10, Direct Primary Care Agreements

11. Busch, F., Grzeskowiak, D., & Huth, E. (2020). Direct Primary Care: Evaluating a New Model of Delivery and Financing. Society of Actuaries / Milliman. DPC patients had 40.51% fewer ER visits and 12.64% lower total cost. SOA/Milliman DPC report (PDF)