How do I know if I might have to pay a facility fee?
If a hospital-based facility located outside of the hospital campus charges a facility fee without utilizing what is called a current procedural terminology evaluation and management (CPT E/M) code for outpatient services, it must provide you with a written notice:
- That the hospital-based facility is part of a hospital or health system
- That you may be charged a facility fee separate from the professional fee charged by the health care provider
- That your actual financial liability will depend on the services provided to you
- That you may be responsible for paying more for the services you receive at their facility than you might have to pay at a facility not owned by/associated with a hospital
- That includes a telephone number you may call for additional information regarding your potential financial liability, including an estimate of the facility fee likely to be charged
- That if you have health insurance, you should speak to your insurance carrier to figure out if you will be responsible for paying facility fees under your specific plan, and if so, how much you might have to pay
Note: Be sure to read the documents you are asked to sign before you receive care. Notices may be provided to you before your appointment or when you arrive. They may be presented to you on paper, or electronically. Ask questions if you do not understand the information.