In October 2026, the Patient Prism research team analyzed 17 published sources to benchmark patient no-show rates by specialty. Those sources range from MGMA benchmarks and 2026 polling to federal survey data and Medicare payment data. They also include two randomized trials and a review of 105 studies. The clinic studies in the set cover nearly 5 million scheduled appointments between 2007 and 2026.1,2,4,5,6,12,15,16 Four types of healthcare organizations are covered: dental and DSO, medical and MSO, hospital outpatient, and veterinary.

Average Patient No-Show Rates by Specialty

A no-show is a patient who misses a scheduled visit without notice; a patient who calls ahead has canceled. MGMA recommends tracking the two separately, because a blended “missed visit” rate hides which one is growing.1 That matters more than usual this year: 32% of medical groups report higher no-shows in 2026.1 Here are the rates by specialty, with the setting and year behind each figure:

Patient No-Show Rates by Specialty, 2026

Vertical / Specialty	Typical No-Show Rate	Data Type	Setting and Sample	Data Year
Medical / MSO: all single-specialty groups (primary care, surgical, nonsurgical)	5% to 7%2	Industry benchmark	MGMA member practices	2019 to 2023
Medical / MSO: neurology, general surgery	About 8%3	Industry benchmark	MGMA practice operations survey	2016
Medical / MSO: primary care with reminders	4% to 6%6	Select study result	Kaiser Permanente Colorado, 54,066 patients	2018
Hospital outpatient: otolaryngology (ENT)	9% to 20%8,9	Directional (two academic centers)	Loyola and University of Kentucky	2015 to 2021
Hospital outpatient: orthopedics	About 12%10	Directional	University of Iowa	2016
Dental / DSO	7% to 10%11	Directional (single university clinic system; not a national benchmark)	US university dental clinics, 180,000+ appointments	2017
Veterinary	About 11%14	Directional (single vendor dataset; not a national benchmark)	250+ veterinary clinics	2014
All specialties, global studies	About 23%4	Peer-reviewed average	105 studies, all continents	2018

 

Key takeaways

•     Benchmarked US medical groups sit in the mid single digits, well below many figures quoted online.
•     Academic and hospital-based clinics run about 9% to 20%. A hospital outpatient department that benchmarks against private-practice data is holding itself to the wrong standard.
•     The dental and veterinary figures each come from a single dataset: one US university dental clinic system and one vendor’s sample of 250+ veterinary clinics. Neither is a national benchmark, so multi-location operators in those verticals set targets without a solid reference point.
•     Treat the global 23% average as context. It mixes many countries and care settings.

New vs. Existing Patient No-Show Rates

New patients are often the hardest and most costly to win, and they also miss more often. Only two of the studies we reviewed split no-shows this way, and both come from academic medical clinics: one in sleep medicine and one in ENT. The table shows the pattern, not a breakdown by specialty.

No-Show Rates for New vs. Existing Patients

Setting	New Patients	Existing Patients	Gap	Data Type
Academic sleep clinic, 2,532 visits	About 31%7	About 18%7	New patients about 1.8x more likely to miss, after adjusting for other factors7	Select study result
Academic ENT clinic, 22,759 visits	About 24%8	Not reported separately; about 20% across all visit types8	New visits had the highest rate of any visit type8	Select study result

 

Key takeaways

•     New patients missed more in both studies, by about 13 percentage points in the sleep clinic.
•     Marketing paid to bring those patients in, so a new-patient no-show wastes acquisition spend on top of exam or chair time. 
•     Track new and existing patients separately at each location; a blended rate can hide the gap.
•     Dental and veterinary groups will need to pull this split from their own scheduling data. No public study in either vertical reports it.

No-Show Rates by Day and Time

When do no-shows cluster? Four studies offer a partial answer, and knowing the pattern helps each location plan around the slots most likely to go empty.

No-Show Patterns by Day and Time

Pattern	Finding	Setting	Data Type
Day of week	Highest on Monday (about 11%), lowest on Friday (about 10%)12	4.5 million hospital outpatient visits, Scotland	Select study result (non-US)
Afternoon by day	Tuesday (about 31%) and Friday (about 32%) afternoons highest13	Academic internal medicine clinic, Texas	Select study result
Time of day	8 to 10 a.m. slots more likely to no-show11	US university dental clinics	Select study result
Season	Summer had the highest no-show rate (about 7%)11	US university dental clinics	Select study result

 

Key takeaways

•     The studies disagree on the worst day. Monday led in one; Tuesday and Friday afternoons led in another.
•     In dental clinics, early mornings and summer months run higher, which affects hygiene scheduling across a network. Before changing templates network-wide, pull each location’s own day-and-hour pattern.

How Reminder Cadence Affects No-Show Rates

Two randomized trials tested how and when to remind patients. Trial 1 ran in academic outpatient clinics in 2007; Trial 2 ran in a large primary care system. Because their starting rates differ, compare results within a trial rather than across them.

How Reminder Cadence Changes No-Show Rates

Trial	Reminder Approach	No-Show Rate	Data Type
Trial 1: academic outpatient clinics, 9,835 visits	No reminder	About 23%5	Select study result
Trial 1	Automated phone reminder	About 17%5	Select study result
Trial 1	Staff phone call, 3 days ahead	About 14%5	Select study result
Trial 2: primary care, 54,066 patients	One reminder, 3 days ahead	About 6%6	Select study result
Trial 2	One reminder, 1 day ahead	About 5%6	Select study result
Trial 2	Two reminders, 3 days and 1 day ahead	About 4%6	Select study result

 

Key takeaways

•     Every reminder approach beat no reminder. In the only head-to-head test, a live staff call beat an automated one.
•     The larger trial’s lowest rate came from two reminders, sent 3 days and 1 day out.
•     Reminders have limits. MGMA’s 2026 poll found that practices with rising no-shows often send the same reminders as practices that improved; cost, transportation, and long wait times are barriers a reminder can’t remove.1

Revenue Lost per No-Show by Specialty

The value of one missed visit varies widely by vertical. The ranges below come from public visit-value data and are rounded national averages, so use them as a starting point.

Revenue Lost per No-Show by Specialty

Vertical	Value of One Missed Visit	Basis	Data Type
Dental / DSO	$350 to $40015	Average paid per office-based dental visit, all payers, 2019 to 2021	Federal survey data
Medical / MSO	$75 to $12516	Established-patient office visit, Medicare national rate, 2026	Public visit-value benchmark
Hospital outpatient	$70 or more16	Physician portion of an established visit in a hospital setting, Medicare national rate, 2026; the hospital’s own facility payment is added on top	Public visit-value benchmark (floor)
Veterinary	$150 to $25017	Revenue per clinical visit, US practices, 2025	Industry trade data

 

Key takeaways

•     Dental groups lose the most per empty slot: a missed dental visit is worth several times a standard medical office visit.
•     The medical and hospital rows rely on Medicare national rates. If your payer mix differs, use your own average visit value.
•     For a quick cost estimate, multiply visit value by monthly no-shows per location. 
•     These figures understate the loss, since a missed new-patient visit also loses the treatment it would have started.

How to Calculate No-Show Rate

A no-show rate is the share of scheduled appointments patients missed without notice.

No-Show Rate Formula

Formula

No-show rate = (no-shows ÷ total scheduled appointments) × 100

 

Appointments canceled with notice stay out of the count. Track those separately so the rate measures one behavior. Some groups also report a nonattendance rate, which adds late cancellations to no-shows; one ENT study found a no-show rate of about 9% and a nonattendance rate of about 18%.9

Say a five-location group schedules 4,000 appointments in a month and records 280 no-shows. Divide 280 by 4,000 and you get 0.07, a 7% no-show rate, within the MGMA range for medical groups.2 At a medical visit value of $75 to $125, those misses come to roughly $20,000 to $35,000 a month.16

Then break the rate out by location and by new vs. existing patients. A location running at twice the rate of the others can hide inside a network average.

What the Data Means for Multi-Location Operators

BI shows what happened. Activation changes what happens next. A no-show rate belongs to the first group: by the time it registers, the slot is already empty. Our analysis reveals that many of the drivers behind patient no-show rates by specialty are operational, not marketing problems. Long wait times are one. Schedule templates that ignore day-and-hour patterns are another. So are wide gaps between locations and follow-up that depends on who is at the front desk.

The rate also leaves out a larger group: patients who called, texted, or filled out a form and never booked. A full schedule starts at that step from inquiry to appointment, which is where Patient Prism’s Revenue Activation System works. It shows which inquiries across phone, text, web forms, and online scheduling never became appointments, and why. Patient Prism tracked 12.4 million calls in the past year, and four barrier categories drive 84% of all non-bookings.18 

Harbour Dental Care grew from 4 to 14 Florida practices. The group uses Patient Prism to see every new patient inquiry across phone and online scheduling. In early 2026, its team converted about 70% of them. Follow-up calls recovered about 30% of abandoned online bookings. Harbour’s own team also places a welcome call to patients who book online, a step the group credits with better show rates. These results come from one deployment, not typical outcomes.19

Get a Demo to see where inquiries fall off across your locations.

Frequently Asked Questions

What is the national average no-show rate?

About 5% to 7% in benchmarked US medical groups.2 A global review of 105 studies puts the average near 23%, though that figure blends many countries and care settings.4

What is the average no-show rate for primary care?

It depends heavily on reminders. A large primary care system that sent them saw rates of about 4% to 6%.6 In an academic clinic trial, patients who got no reminder missed about 23% of visits.5

What is a good no-show rate benchmark?

Start with each location’s own prior-year rate, measured the same way; MGMA recommends this approach.1 Then compare each location against the patient no-show rates by specialty in the first table.

 

References

1. MGMA. “About 1 in 3 medical groups see higher no-shows in 2026 as patients face higher costs.” MGMA Stat, 2026. https://www.mgma.com/mgma-stat/about-1-in-3-medical-groups-see-higher-no-shows-in-2026-as-patients-face-higher-costs
2. MGMA. “No-show fees in medical practices on the rise to balance bumpy attendance rates.” MGMA Stat, 2025. https://www.mgma.com/mgma-stat/no-show-fees-in-medical-practices-on-the-rise-to-balance-bumpy-attendance-rates
3. MGMA. “30 ways to reduce patient no-shows.” https://mgma.com/blog/30-ways-to-reduce-patient-no-shows
4. Dantas, L.F., et al. “No-shows in appointment scheduling: a systematic literature review.” Health Policy, 2018. https://doi.org/10.1016/j.healthpol.2018.02.002
5. Parikh, A., et al. “The effectiveness of outpatient appointment reminder systems in reducing no-show rates.” American Journal of Medicine, 2010. https://pubmed.ncbi.nlm.nih.gov/20569761/
6. Steiner, J.F., et al. “Optimizing number and timing of appointment reminders: a randomized trial.” American Journal of Managed Care, 2018. https://www.ajmc.com/view/optimizing-number-and-timing-of-appointment-reminders-a-randomized-trial
7. Journal of Clinical Sleep Medicine. Sleep clinic no-show study, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7970619
8. “Factors Associated with Patient No-Show Rates in an Academic Otolaryngology Practice.” University of Kentucky. https://pmc.ncbi.nlm.nih.gov/articles/PMC5814324
9. Yuhan, B.T., et al. “No-Show Rates in an Academic Otolaryngology Practice Before and During the COVID-19 Pandemic.” Cureus, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC10929764
10. University of Iowa orthopedics no-show study (appointment times and subspecialty). Journal of Healthcare Management, 2018. https://iro.uiowa.edu/esploro/outputs/journalArticle/Correlation-of-Appointment-Times-and-Subspecialty/9984040329702771
11. Lapidos et al. Public Health, 2017. Reported in Dr. Bicuspid, “Study: 5 factors that affect no-shows and cancellations.” https://www.drbicuspid.com/dental-practice/article/15373542/study-5-factors-that-affect-no-shows-and-cancellations
12. Ellis, D.A., and Jenkins, R. “Weekday affects attendance rate for medical appointments: large-scale data analysis and implications.” PLOS ONE, 2012. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0051365
13. American Association for Physician Leadership. Temporal characteristics of missed clinic appointments at an academic center in West Texas. https://physicianleaders.org/articles/temporal-characteristics-missed-clinic-appointments-academic-center-west-texas
14. PetDesk. “What pesky no-shows actually cost your veterinary practice.” https://petdesk.com/blog/what-pesky-no-shows-actually-cost-your-veterinary-practice
15. Olaisen, R.H., and Manski, R.J. “Dental Utilization and Expenditures, U.S. Civilian Noninstitutionalized Population Aged 2 and Older, 2019-2021.” AHRQ Statistical Brief #555, 2024. https://meps.ahrq.gov/mepsweb/data_files/publications/st555/stat555.shtml
16. Centers for Medicare & Medicaid Services. “Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F).” Fact sheet, 2025. https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f
17. Global Pet Industry. “2023-2025: Cats gain ground in US vet clinics as visit volumes decline.” Reporting CATalyst Council data. https://globalpetindustry.com/news/2023-2025-cats-gain-ground-in-us-vet-clinics-as-visit-volumes-decline/
18. Patient Prism. Homepage. https://www.patientprism.com/
19. Patient Prism. “Patient Prism x Harbour Dental Care.” Case study, 2026. https://www.patientprism.com/case-study/harbour-dental-care/