CommentRichard Klasco, M.D.November 5, 2019Q: I was recently charged a “facility fee” for seeing my doctor, doubling the cost of my visit. What is the facility fee?
The purpose of the facility fee is to compensate hospitals for the expense of maintaining the physical premises. Hospital-owned, off-campus medical practices are also allowed to charge the facility fee to cover specific regulatory requirements, such as building codes, disaster preparedness, equipment redundancy and other items that are largely invisible to patients.
How much more you might have to pay depends on the complexity of your visit and whether you are a new patient. For new patients, whose visits entail more work than those of established patients, facility fees typically range from $131 to $322 per visit; for established patients, they are slightly lower. In surgical centers and free-standing emergency rooms, the facility fee can be thousands of dollars.
The portion of the facility fee that you have to pay depends on your insurance plan. “Gold plans” usually cover a percentage of the facility fee at in-network facilities, but “bronze plans” often do not. At out-of-network facilities, costs will be higher, and coverage will be less. With all plans, you will be responsible for the entire facility fee until your deductible has been satisfied. Thus, facility fees can easily add a thousand dollars or more to a family’s annual health care costs.