Could facility fees for telehealth appointments return?

Hospital facility fees have been a controversial staple of billing, and now they may apply to telehealth appointments more frequently, Kaiser Health News reported Dec. 17.

Facility fees can add hundreds or even thousands of dollars to a patient's bill and have come under criticism from patients and consumer groups. Hospitals argue these fees are necessary for keeping their facilities operational. Fees for video appointments are rare but have taken a few patients by surprise.

When a patient booked a video appointment at Yale New Haven (Conn.) Health, she was surprised to receive a facility fee despite never setting foot in the hospital. The hospital told the patient that because her physician would be on hospital property, it still had to charge the fee. 

"The charges seem crazy," Ted Doolittle, head of Connecticut’s Office of the Healthcare Advocate told KHN. "It rankles, and it should."

As it turns out, Connecticut banned facility fees for telehealth appointments as part of broader laws that aimed to improve access to telemedicine throughout the COVID-19 pandemic, meaning the aforementioned patient was wrongly billed for her appointment. 

Pat McCabe, senior vice president of finance at Yale New Haven Health, defended the use of facility fees in virtual visits. 

"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 told KHN.

In 2021, only 1.1 percent of telehealth appointments included a facility fee. As telehealth continues to be used post-pandemic, it is unclear how appointments will be billed. 

Mr. McCabe said Yale New Haven Health plans to implement the fees as soon as the state allows.

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