Hospitals Charging Patients a “Facility Fee” for Video Visits

By Consumers For Quality Care, on January 19, 2022

When a Connecticut woman’s 9-year-old son needed to see a pediatric specialist at Yale New Haven Health System in June 2021, the hospital billed her for a “hospital facility fee”—even though she and her son conducted the visit by video.

According to Kaiser Health News, Arielle Harrison called the hospital’s billing office the next morning and was told the facility fee is based on where the doctor is located. Since the doctor would be on hospital property, the hospital would charge a facility fee of between $50 and $350, depending on her insurance coverage.

“It’s just one of many examples of how this is a very difficult system to use,” Harrison said, referring to the complexities of the U.S. health care system. Harrison, who works in nonprofit communications, took to Twitter to post about the unwelcome fee.

Hospitals say that facility fees are necessary to cover the high cost of keeping a hospital open and ready to provide care 24/7. Over the past several years, hospitals have been buying up physician practices and often then begin charging the fees. Patients seeing the same doctor in the same office now must pay the extra fee—simply because of a change in ownership.

Charging a facility fee for a video visit where the patient logs in from home is even more puzzling.

“The charges seem crazy,” said Ted Doolittle, who leads Connecticut’s Office of the Healthcare Advocate, which helps consumers with health coverage issues. “It rankles, and it should.”

Health finance experts maintain that facility fees for video appointments remain rare, even as the use of telehealth has skyrocketed during the COVID-19 pandemic.

Doolittle reached out to Harrison after seeing her tweet to offer his office’s assistance. Fortunately, Connecticut banned facility fees for telehealth visits as part of a law passed in May 2021. The prohibition on facility fees sunsets at the end of June 2023.

Pat McCabe, senior vice president of finance at Yale New Haven Health System, speculated that Harrison’s son’s appointment may have been billed incorrectly, which led to her being charged a facility fee.

However, McCabe said that such fees are justified and that he expects the Yale New Haven Health System to reinstitute the facility fees when state law permits. “It offsets the cost of the software we use to facilitate the telehealth visits, and we do still have to keep the lights on,” he said. “There are real costs in the health system to provide those services.”

CQC urges insurers to permanently cover telehealth services even after the COVID-19 pandemic public health emergency is over and do away with unnecessary fees associated with telehealth services and other physicians visits that hurt consumers from accessing the health care they need.