Longitudinal Family Medicine payment model

Longitudinal Family Medicine payment model

The Longitudinal Family Medicine (LFM) payment model offers competitive compensation and enhanced accountability, through a blended payment that is calculated based on hours worked, panel size and services delivered.

About the LFM payment model

It’s projected that family physicians working full-time to provide longitudinal family medicine will earn, on average, about $365,000 annually under the new Longitudinal Family Medicine (LFM) model (up from about $300,000 under the previous APP – an increase of about 20%). Adding hours to your schedule and patients to your roster, providing additional services or becoming a preceptor all deliver the opportunity to earn even more.

The best part? You’re paid for the hours worked, services delivered and patients rostered to your practice.


Physicians under the LFM model will be paid a blended payment that is calculated based on hours worked, services delivered and panel size.

  • Hours worked: $95.48 per hour (weekdays); $143.22 per hour (evenings/weekends)
  • Services delivered: 30% of fee-for-service billings, with enhanced fee codes in place
  • Panel size: $106.09 per patient

Note: these fees will increase by 2% on April 1, 2025

In this model, a physician may earn more or less by working more/fewer hours, delivering more/fewer services and/or growing/shrinking their panel size. The model is also flexible – a physician could work full-time or part-time and still participate in this model. They could also work part-time within a longitudinal family practice and part-time providing care in other areas of the system, such as providing hospitalist or emergency services or working in a sexual health clinic.

Income smoothing

Having a stable and reliable income is vitally important. Having payments accurately reflect the hours worked, services billed and panel size is also essential. Physicians paid under the LFM model will be paid biweekly (every two weeks) and their income will be smoothed. We expect smoothing to look like this:  

  • Hours – Smoothed annually based on contracted hours as outlined in your Contracted Activities (Schedule A to the LFM Contract); reconciled at the end of the year to ensure hours paid matched hours worked. If a physician worked more hours, they will then be paid for the extra hours.
  • Billing – Based on actual billing claims submitted (no smoothing)
  • Panel – Smoothed quarterly (payment based on panel size at the beginning of each quarter)

How do I know if it’s right for me?

The LFM is right for you if you:

  • Bill ME=CARE (comprehensive, continuous, cradle-to-grave care) for patients you would consider attached to you, with the patients considering you their family doctor
  • Work 46 weeks per year in office-based clinical practice (exceptions include weeks doing other clinical work approved by Nova Scotia Health (NSH), such as hospitalist work)
  • Provide most direct clinical services in face-to-face patient encounters 
  • Provide an average of 2.8 or more service encounters per hour
  • Use an EMR 
  • Take a maximum of six weeks away from your practice each year for educational leave, sick time, holidays and vacation time

Next steps