DPC Practices Are Posting Their Employer Rate Sheets on Mark Cuban's Contract Platform. Two of Them Price Above the Federal HSA Ceiling.

Mark Cuban’s direct-to-employer contracting site does something almost nobody in healthcare does. It posts the contract. Not a summary, not a rate range, the actual signed-form document with the price schedule inside it, free to download.

Direct Primary Care showed up there in July and kept arriving. Six listings as of September 24, four of them solo practices. Put their rate sheets side by side and a federal line runs straight through the middle of them.

The line

Since January 1, 2026, an employee can stay eligible to contribute to a health savings account while enrolled in a direct primary care arrangement. The IRS set the conditions in Notice 2026-5, following the change the One Big Beautiful Bill Act made to Section 223 of the tax code. The fee has to stay at or below $150 a month for one person, or $300 a month for two or more, and the arrangement has to cover primary care only.

That number has been sitting there all year. What changed in July is that DPC prices started getting published next to each other.

What is actually listed

Cost Plus Wellness runs on one rule: the provider posts the contract, and any self-funded employer can read it without asking. The directory runs on contract IDs, starting at C001, a Texas oncology group posted in November 2024, and most of what sits between then and now is specialty care.

The first DPC entries went live in the same nine-day stretch. Arche Health in Albuquerque on July 6. Burds Family Practice in Peosta, Iowa, and Pillar Healthspan in Little Rock, both on July 14. Mending DPC on July 15. Two more landed on September 24: Direct Primary Care of Southeast Texas in Beaumont, and Fruitful Oaks Direct Primary Care in Oklahoma.

None of the July entries is filed as Direct Primary Care. The three clinics sit under Family Medicine. Mending sits under Service Provider. A DPC physician browsing the directory by specialty would scroll past every one of them, which is roughly what happened: a September 22 column in DPC News pointed physicians at the platform and reported that no pure DPC clinics appear in the listings. The contracts themselves say otherwise. Burds attaches a supporting file titled “Direct Primary Care agreement.” Pillar’s document is headed “Direct Primary Care Services Agreement.” Arche’s is an “Employer - DPC Membership Agreement.” Two days after the column ran, Fruitful Oaks posted under the specialty “Family Medicine / Direct Primary Care,” the only listing that says it on the label.

The prices

Burds is a solo practice and its rate sheet is the shortest document in the set. $99 a month for an adult age 19 and over, $79 for a spouse or domestic partner, $49 for a child. A one-time onboarding fee of $100 per employee. Minimum enrollment: one employee. Rates guaranteed for twelve months.

Burds comes in under the federal dollar limits. An adult at $99 sits under $150. An adult and a spouse together at $178 sit under $300.

Arche Health charges $199 per enrolled employee per month and $179 per adult dependent, with children under 18 included at no additional monthly charge. Onboarding runs $150 per employee or $300 per family, and the employer has to enroll at least five people. Prepay the year and the effective rate falls to $179.10, still above the cap.

Pillar Healthspan prices at $1,999 per enrolled member per year, which its own contract converts to $166.58 a month. Virtual care is unlimited at no charge. In-person visits beyond the included assessments cost $40 each.

And Pillar states the consequence in its own document, at Article 7.2:

“At the fee level and structure set forth in Article 2, this arrangement does not satisfy the fee and sole-compensation conditions of the federal direct primary care safe harbor applicable to health savings account eligibility (26 U.S.C. § 223, as amended; IRS Notice 2026-05).”

Two separate things break it there. The monthly equivalent clears the dollar cap, and the $40 visit fee means the membership is not the only compensation the practice receives for the care.

The two September arrivals price lower than either. Direct Primary Care of Southeast Texas, a solo practice in Beaumont, bills the employer $90 a month for an employee, $90 for a spouse, and $50 a month for a child aged 13 to 17 or a full-time student aged 18 to 26. Labs and clinic-administered medications sit outside that fee, and the employer fills in what percentage of them it will cover. Fruitful Oaks charges $75 a month for an adult, $35 for a child enrolled alongside a participating adult, and $45 for a child on their own. There is no enrollment fee, and the practice agrees to hold those rates for at least 24 months.

What Mending is selling instead

Mending Technologies runs a national DPC network rather than a clinic, selling employers access to independent practices, and its contract is the only one in the set built for scale. The employer has to sponsor a self-funded ERISA plan with at least 50 employees. It pays Mending $3.50 per employee per month as a network rental fee, then $90 to $100 for each activated adult member and $60 to $70 for each activated child.

The billing trigger is the part worth copying. A membership fee starts only when the participant joins a participating practice and has a documented clinical encounter that month. Eligibility, signup, account creation and appearing on a roster all bill nothing, and section 4.3 names all four rather than leaving them to implication.

Mending lists licensure in all 50 states and the District of Columbia. Its adult range tops out at $100, which keeps the membership line inside the HSA cap.

Why a year-old cap suddenly has teeth

Practices have quoted monthly fees for a decade without anyone running them against a federal number. The cap didn’t change that by existing. Downloadable rate sheets, sitting in one public directory, did. A benefits manager comparing Burds against Pillar can check the arithmetic in about a minute, and the answer is on page one of each document.

Nothing improper is happening at Arche or Pillar. A DPC fee above $150 puts the arrangement outside the notice’s definition of a direct primary care service arrangement. What that costs is the HSA safe harbor, and it might still be the right price for what those two practices deliver. Pillar caps enrollment per care team at roughly a quarter of the panel size typical of insurance-based primary care, and commits to a same-day or next-business-day response standard with a 5 percent invoice credit if it misses 90 percent in a quarter. Arche covers every child under 18 at no additional charge. What those practices give up is the tax wrapper, and only for the subset of employees holding an HSA-qualified high-deductible plan.

The counterargument

The strongest objection is that the $150 figure is a tax-eligibility condition, not a price ceiling, and treating it as one is a category error. In an employer-sponsored arrangement the employer pays, out of plan dollars, and the covered employee may hold no HSA at all. If a company’s medical plan isn’t high-deductible, the safe harbor is irrelevant to it, and $199 is just a price the employer either accepts or declines. Arche’s contract prices a service that covers every child under 18 at no additional monthly charge, which no reading of Section 223 rewards.

That objection holds for any single employer. It stops holding across a market. Mending’s negotiated range of $90 to $100, Burds’ $99, Southeast Texas’ $90 and Fruitful Oaks’ $75 all land under the line. Two practices deliberately pricing past it are betting that employers value what they’ve built enough to surrender the HSA option for part of the workforce. That bet used to be private. It is now a PDF anyone can open, which is what publishing prices was supposed to do to everyone, DPC included.