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Hospital Facility Fees Up for Discussion Again as Out of Pocket Costs Rise for Patients When Hospitals Buy Physician Practices A

Posted Dec 31 2012 12:51am

Facility fees are allowed by Medicare for hospitals to charge and these are tacked on, separate from medical services received.  More and imagemore of these types of charges are appearing on medical bills, especially ones set up for outpatient services.  Sometimes insurers do not pay the fees and thus some patients begin looking for doctors who do not have this charge.  Facility fees are amounting up to a billion dollars a year that Medicare pays, so you wonder what is accomplished here as practices can charge more that are owned by hospitals too so does Medicare get the double whammy when they are trying to save money? 

So as a patient, pay attention if you can to if your doctor’s practice was sold to a hospital as you may begin seeing those soon.  The story quotes one woman getting a facility or services fee for 8k, so of course that was negotiated down by the insurance company and and she ended up having to pay over a thousand of that fee.  Better disclosure is certainly needed as they are not always posted either.  They all do it and back in 2009 I wrote about the fee that Cleveland Clinics charge and the $55.00 fee looks rather small compared to what is being charged now with some of these fees.  BD

Cleveland Clinic “facility fee” or “hospital services fee” has Patients up in Arms


One family accustomed to paying about $120 in out-of-pocket costs for doctor visits and other medical services was outraged when their costs for similar visits soared to $1,000, Mullin said.

The reason for the increase: The physician practice had been bought by a local hospital, and “all of a sudden everything was charged differently,” said Mullin, a Republican.

The higher bills reflected “facility fees.” For years, hospitals that own physician practices and outpatient clinics have been allowed by Medicare to tack on these fees, separate from bills for doctors’ services, for the use of the facilities. As hospitals buy up medical practices and set up outpatient treatment centers, more of these fees are showing up on patients’ bills.

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