[Rainger99]

I just saw this article on facility fees. I had never heard of them but it seems like a new scam.

Has anyone been charged facility fees??

Did your doctor'''s office charge you a '''facility fee'''? Here'''s what to know.

[Taltarzac725]

Originally Posted by Rainger99

I just saw this article on facility fees. I had never heard of them but it seems like a new scam.

Has anyone been charged facility fees??

Did your doctor'''s office charge you a '''facility fee'''? Here'''s what to know.

One of the nightly national news stations had something on the other night. I flip around so not sure which one.

[Taltarzac725]

Originally Posted by Michael G.

Another news media drumming up fake news.

What is a facility fee and why is it important to you? | UCHealth What is a facility fee and why is it important to you? | UCHealth


Not fake news .

[Rainger99]

Originally Posted by Michael G.

Another news media drumming up fake news.

So these stories are false? These people were not charged facility fees?

After Cleveland Clinic expanded to Florida, patients say surprise fees followed

Just a moment...

[tophcfa]

Originally Posted by Rainger99

I just saw this article on facility fees. I had never heard of them but it seems like a new scam.

Has anyone been charged facility fees??

Did your doctor'''s office charge you a '''facility fee'''? Here'''s what to know.

Bummer, but shouldn’t be an issue for those with a good Medicare Supplemental Plan.

[Rainger99]

Originally Posted by tophcfa

Bummer, but shouldn’t be an issue for those with a good Medicare Supplemental Plan.

Under Original Medicare, facility fees are a covered service, and you are responsible for 20% of the cost of the fee. Medicare Advantage Plans must also cover facility fees, but there is no requirement as to how much of the fees the plan must cover. Because of this, your copays could be high. If your Medicare Advantage Plan denies coverage for the facility fee, you should appeal on the basis that Medicare Advantage Plans must cover the same services covered by Original Medicare.

If you have Advantage, it is probably a good idea to contact the doctor and the insurance company in advance to find out if there is a facility fee and, if so, how much is paid by the insurance company.

[CoachKandSportsguy]

There are medical fees: doctor nurse drug charges.
There are facility fees: rent, maintenance, EMR costs.

The facility fees are the overhead costs associated with the building and the systems involved in operating in the medical world. Its separate because of how contracts are written, especially after the installation of EMR systems, and their ongoing costs and requirements for CMS reporting.

Not a scam, just separating charges. . with all other commercial companies, the labor rate usually includes the burdened overhead rate. for hospital billing, its now broken out as the doctor and the facility fees are different vendors.

[bopat]

I charge a patient fee.

[Rainger99]

Originally Posted by CoachKandSportsguy

There are medical fees: doctor nurse drug charges.
There are facility fees: rent, maintenance, EMR costs.

The facility fees are the overhead costs associated with the building and the systems involved in operating in the medical world. Its separate because of how contracts are written, especially after the installation of EMR systems, and their ongoing costs and requirements for CMS reporting.

Not a scam, just separating charges. . with all other commercial companies, the labor rate usually includes the burdened overhead rate. for hospital billing, its now broken out as the doctor and the facility fees are different vendors.

According to the article, the fee is being charged by doctors that have been bought out by hospitals. It doesn’t appear that the doctor’s costs have gone up.

Facility fees are commonly seen in hospital-owned outpatient clinics and are increasingly appearing in other outpatient settings when hospitals acquire physician practices.

Didn’t the doctor have rent and maintenance before they started charging facility fees?

This is like a hotel charging $300 a night for the room and then adding on a mandatory resort fee.

The doctor’s fee should be the total cost of providing services plus an added fee for profit.

If you start breaking everything down, the fees are endless.

If a doctor really wants to make money, the doctor could also add a fee for utilities, office cleaning, an office staff fee, a Christmas party fee, etc., etc.

[CoachKandSportsguy]

Originally Posted by Rainger99

According to the article, the fee is being charged by doctors that have been bought out by hospitals. It doesn’t appear that the doctor’s costs have gone up.

Facility fees are commonly seen in hospital-owned outpatient clinics and are increasingly appearing in other outpatient settings when hospitals acquire physician practices.

Didn’t the doctor have rent and maintenance before they started charging facility fees?

This is like a hotel charging $300 a night for the room and then adding on a mandatory resort fee.

The doctor’s fee should be the total cost of providing services plus an added fee for profit.

If you start breaking everything down, the fees are endless.

If a doctor really wants to make money, the doctor could also add a fee for utilities, office cleaning, an office staff fee, a Christmas party fee, etc., etc.

its a billing distinction, of pure doctor / medical and then rent, overhead, etc.
yes, it used to be all in one. . and i will check to see when and who, i suspect CMS, started demanding the two be split out, so that all medical services are identified separately from rent/ operational overhead. medical then should be billed per procedure to medicare. . facilities are dependent upon the local situation. .

the biggest problem is that there are two bills instead of one now.

[Rainger99]

Originally Posted by CoachKandSportsguy

its a billing distinction, of pure doctor / medical and then rent, overhead, etc.
yes, it used to be all in one. . and i will check to see when and who, i suspect CMS, started demanding the two be split out, so that all medical services are identified separately from rent/ operational overhead. medical then should be billed per procedure to medicare. . facilities are dependent upon the local situation. .

the biggest problem is that there are two bills instead of one now.

When they split the cost two ways - doctor/medical and rent/overhead - did the doctor/medical fee go down?

[Stu from NYC]

Originally Posted by Rainger99

When they split the cost two ways - doctor/medical and rent/overhead - did the doctor/medical fee go down?

Of course not.

[asianthree]

For years if a physician had a on-site procedure room, facility fee was listed separately for use of the room.

[Rainger99]

Originally Posted by asianthree

For years if a physician had a on-site procedure room, facility fee was listed separately for use of the room.

What is a procedure room? I have been to a dermatologist and they usually perform a “procedure” on me. Does that qualify?

[CoachKandSportsguy]

via Google:

Key Hospital Bankruptcies and Related Events in 2025:
Prospect Medical Holdings: Filed for Chapter 11 bankruptcy in January, citing financial difficulties and seeking to restructure its operations and potentially sell some of its hospitals.
Steward Health Care: Filed for Chapter 11 bankruptcy in early 2025, leading to the closure of some facilities and a focus on restructuring.
The Bellevue Hospital (Ohio): Filed for Chapter 11 bankruptcy and is planning to be acquired by Firelands Health.
East Ohio Regional Hospital: Closed down on March 27 due to ongoing financial issues.
Landmark Holdings of Florida: Filed for Chapter 11 bankruptcy in March, citing financial problems.
Houston Healthcare: Finalized a definitive agreement to join Emory Healthcare.
Jackson Hospital (Montgomery, Alabama): Filed for Chapter 11 bankruptcy.
3 others were acquired before bankruptcy

Factors Contributing to Bankruptcies:
Rising Operational Costs: Hospitals face increased expenses related to labor, supplies, and energy.
Funding Constraints: Difficulty accessing capital and navigating complex regulations.
Medicare Advantage Reimbursement Rates: While Medicare Advantage rates are set to increase in 2026, providers continue to face pressure on reimbursement.
Labor Shortages: Workforce shortages contribute to increased costs and operational challenges.
Private Equity Ownership: Concerns about the impact of private equity ownership on hospital finances and patient care.

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We are only 1/2 way through the year. .
If you think your healthcare isn't going to bill you for every last dime they can. .
so if you want healthcare to exist near you, pay the damn facility fee. . .

And yes, the area hospital in the town where my mom lived, and I grew up, now has no regional hospital. . emergency room is now 45 minutes away, there are several schools systems there, high potential sports injuries,

check out the Healthcare sector valuation in the stock market, lowest of all the sectors, with the weakest earnings growth. .
the US system was the best in the world, and it was the most expensive. . then all of a sudden, with such great health care, people started living alot longer, and the medicare system started costing alot of money in the govt budget. . . and then power hungry people started cutting taxes to get elected. .

shades of 476 AD