JUN 09, 2023
Charging Convenience Fee
I wanted to start charging patients a 3% convenience fee for using a credit card to cover my processing expenses. However, I was told by my colleagues that I am not allowed to charge patients more if I am credentialed with their insurance plans. Is this correct?
Answer:From
Fundamentals of Ophthalmic Coding: Medicare is clear that fees charged to patients above and beyond what is allowed based on the fee schedule are prohibited. The Department of Health and Human Services’ Office of Inspector General (OIG) stated in March 2004 that charging extra for services covered by Medicare constituted a potential assignment violation and may be subject to civil monetary penalties.
Any fees, including interest or statement fees are considered beyond Medicare’s deductible and coinsurance. Additional administrative costs are to be absorbed by the practice. The only exception is a charge for missed appointments that must be consistent with all patients (CMS 30.3.13 – Charges for Missed Appointments).
For commercial payers, review your participating provider contract for guidance.
Credit card convenience fees cannot be applied when using Health Savings Account (HSA) or Flexible Spending Account (FSA) credit cards as they are not a qualified medical expense. See IRS Publication 502 for a list of qualifying expenses.
The charging of convenience fees can also be governed by state law, verify for your individual state.