Hospitals Expand Facility Fees on Outpatient Visits, Raising Patient Costs

Hospitals across the U.S., including the Cleveland Clinic system in Florida's Treasure Coast, have increasingly imposed outpatient facility fees on routine medical appointments. These fees, ranging from about $95 to $174 per visit, are traditionally charged for inpatient and emergency services but are now applied to outpatient office visits within facilities classified as hospital outpatient departments.

This shift reflects the growing trend of hospitals acquiring physicians' practices, which now account for over half of all physicians employed nationally, up from 25% in 2012. Facility fees often are not fully covered by insurance, imposing additional out-of-pocket costs on patients, particularly those with high-deductible plans whose average deductibles have risen significantly in recent years. Patient advocates and insurance companies have criticized facility fees for increasing healthcare costs without clear improvement in patient care quality and transparency. Efforts to regulate or limit these fees have bipartisan support at both state and federal levels. In Florida, legislation mandates better disclosure of facility fees to patients before appointments, although full implementation is pending.

Hospital associations argue these fees are necessary to cover the higher costs of maintaining hospital-grade outpatient facilities, including compliance with stricter safety and quality standards. This ongoing dynamic creates tension between affordability concerns for patients and financial pressures on health systems. Some patients respond by seeking care from independent practices to avoid these fees, often at the expense of travel and convenience. The debate around facility fees illustrates broader cost, regulatory, and market trends impacting healthcare delivery and insurance reimbursement in the United States.