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    OB/GYN malpractice tail coverage cost & exit guide

    In OB/GYN, mature claims-made malpractice tail coverage averages $136,000 (ranging from $90,000 to $220,000 depending on geographic risk and claim history). See your exit exposure and copyable negotiation language.

    Median Tail Cost (2×)

    $136,000

    Standard 200% mature claims-made premium

    Annual Premium Range

    $68,000

    $45,000 (low-risk) – $110,000 (high-risk)

    2026 wRVU Efficiency Cut

    −$3,373/yr

    65% procedural share (101 wRVUs/yr lost)

    Target Annual wRVUs

    6,200

    Standard full-time clinical benchmark

    Exit liability: what you owe if you leave

    Comparison of out-of-pocket tail liability at 1, 2, and 3 years under a standard employee-paid clause vs. a negotiated 3-year vesting schedule.

    Departure TimingIf Employee Pays 100%With 3-Year Vesting (Negotiated)If Terminated Without Cause
    End of Year 1$136,000$91,120 (33% vested)$0 (Employer pays)
    End of Year 2$136,000$44,880 (66% vested)$0 (Employer pays)
    End of Year 3+$136,000$0 (100% vested)$0 (Employer pays)

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    OB/GYN malpractice profile & clinical risk

    Highest tail liability among common specialties. In high-risk states (NY, FL, IL), tail can exceed $150,000–$250,000.

    Statute of Limitations Risk

    In medical malpractice, the discovery rule and extended reporting for pediatric or obstetric claims can extend liability long past employment termination. Leaving without tail coverage exposes your personal assets to claims filed years after leaving the practice.

    2026 CMS wRVU Efficiency Adjustment

    CMS finalized a 2.5% reduction on work RVUs for procedural services starting in CY2026. Because OB/GYN has a 65% procedural share, unadjusted employment agreements will generate approximately −$3,373 less in production incentive pay for identical patient volume.

    Negotiation Counter-Offer

    Tail coverage upon dismissal

    Industry benchmark: Attorney commentary describes employer-paid tail upon dismissal without cause (or 3-year vesting) as the standard compromise.

    If Employer terminates this Agreement without Cause, or Physician terminates for Employer's uncured material breach, Employer shall purchase tail coverage (or provide equivalent prior-acts coverage) at Employer's expense with limits no lower than those in effect during employment.
    Negotiation Counter-Offer

    2026 wRVU rate restatement

    Protects against CMS CY2026 −2.5% efficiency cut on OB/GYN procedural codes (~$3,373/yr).

    For services in 2026, work RVUs shall be calculated using the 2025 CMS work RVU values, or the conversion factor shall be adjusted so that Physician's compensation for the same services is not reduced by the CMS efficiency adjustment.

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