An independent medical examination typically costs between $1,000 and $5,000, though a basic evaluation by a general practitioner can run as low as $700 and a complex specialist exam with heavy record review can climb well above $5,000. In almost every situation, you won’t pay for it. The insurance company, employer, or opposing party that requested the exam covers the bill.
The price still matters to you, because it shapes how the requesting party approaches your claim and because a missed appointment or a second opinion can put the cost on your side of the ledger.
Typical Price Ranges
No government database tracks IME fees nationally, so the available figures come from industry surveys. Within those, three variables move the price more than anything else: the physician’s specialty, the volume of records to review, and where the exam takes place.
A basic IME with a general practitioner or occupational medicine physician generally falls in the $700 to $1,500 range. Specialist evaluations by neurologists, orthopedic surgeons, or psychiatrists more commonly land between $2,000 and $5,000. Unusually complex cases occasionally exceed that ceiling.
Specialists charge more because their training is longer, their availability is tighter, and the conditions they evaluate are more involved. Geography also matters. Fees in major metros with high overhead tend to run higher than in smaller cities and rural areas. A physician who testifies often and carries strong credentials can charge a premium because attorneys and insurers seek out that credibility.
Record volume is the quieter cost driver. Physicians bill for time spent reading your medical history before the exam. A soft-tissue injury with a thin file might add an hour of review; a traumatic brain injury case with imaging, neuropsychological testing, and years of rehab notes could add five to ten hours.
What the Base Fee Covers
A quoted IME fee usually bundles several services, though some physicians itemize them. The bundle generally includes:
- Medical record review before the appointment. In complex cases this can account for more of the total cost than the exam itself.
- The face-to-face examination, which may last from 20 minutes to over an hour. Neurological and psychiatric IMEs tend to run longer than orthopedic ones.
- A written report, commonly 10 to 20 pages, summarizing findings, diagnoses, opinions on causation, and prognosis.
- Administrative coordination: scheduling, obtaining records, and communicating with the requesting party’s office.
If the exam is arranged through a scheduling intermediary or IME management company, the sticker price may differ from what the physician charges directly, because the intermediary adds coordination fees.
Charges That Fall Outside the Base Fee
Several services are almost always billed separately, and they can add up quickly.
Record review time is sometimes unbundled and billed hourly. Rates commonly range from $350 to $500 per hour depending on specialty. Deposition testimony and court appearances are billed separately at hourly rates that frequently fall between $400 and $1,000 per hour, with retainers often required in advance.
Supplemental reports and addendum opinions triggered by new medical records are typically separate line items as well. Before agreeing to a fee, ask explicitly whether the quote is all-inclusive or covers only the exam and the initial report.
Retainers and Prepayment
Many IME physicians require a retainer before confirming a date. A common arrangement is a prepaid minimum of several hours credited toward the final bill. For depositions and trial testimony, prepayment requirements are stricter: physicians frequently require the full first-day fee weeks in advance, with the retainer nonrefundable once work begins. This is standard practice in the field.
Who Pays for the Exam
The party that requests the examination almost always pays for it. What that looks like depends on the type of case.
- In personal injury and auto accident claims, the defendant’s insurance company or defense attorney arranges and pays for the IME. The claimant owes nothing for the exam itself.
- In workers’ compensation claims, the employer or its workers’ compensation insurer covers the cost. Many states also require the insurer to reimburse reasonable travel expenses and lost wages for the time you spend attending.
- In disability insurance disputes, the disability insurer pays. Most long-term disability policies include a clause allowing the insurer to require periodic IMEs at its own expense.
- In court-ordered examinations under Federal Rule of Civil Procedure 35, the court can order a party to submit to a physical or mental examination when that person’s condition is genuinely in dispute, and the requesting party typically bears the cost.1Legal Information Institute. Federal Rules of Civil Procedure Rule 35 – Physical and Mental Examinations
Sometimes an individual pays out of pocket. That usually happens when someone seeks a second opinion to counter an insurer’s IME, or when no active legal claim is involved. Attorneys sometimes front the cost and seek reimbursement from a future settlement. Standard health insurance does not cover IMEs, because the exam is a legal or claims-related service, not a treatment visit.
No-Show and Cancellation Fees
Missing a scheduled IME without adequate notice triggers a no-show fee that can be steep. Industry survey data from 2024 put the average no-show fee at roughly $955, though individual physicians charge anywhere from a few hundred dollars to well over a thousand depending on specialty and the time already blocked.
The requesting party usually absorbs that fee initially. In workers’ compensation and insurance contexts, though, an unexcused no-show can also lead to suspension of benefits until you comply, so the real cost extends well beyond the invoice. If you have a legitimate conflict, raise it through your attorney before the appointment rather than skipping it.
Getting an Itemized Fee Agreement
If you’re the one arranging the IME, put the fee agreement in writing before the exam is scheduled. A good agreement breaks out the base examination fee, the hourly record review rate, the report preparation charge, and any fees for deposition or testimony. Knowing the breakdown up front prevents billing surprises and gives you a basis for challenging unreasonable charges later.
Insurers and large defense firms that refer regularly can sometimes negotiate per-exam rates. Individual claimants paying out of pocket have less leverage, but it’s worth asking whether the physician offers a flat rate that includes the report.
State Fee Schedules in Workers’ Compensation
In workers’ compensation cases, many states maintain fee schedules that cap what physicians can charge for various examination and reporting services. If a charge exceeds the applicable schedule, the insurer or employer may have grounds to dispute the excess, and some states run formal administrative processes for resolving medical fee disagreements.
If you believe an IME charge is unreasonable, request the itemized bill and compare it against your state’s workers’ compensation fee schedule, if one exists. That comparison is the practical starting point for any dispute over what the exam should have cost.