Facility fees pay for your care team beyond your doctors, who usually bill separately.
The fee is based on the staff members who care for you and the complexity of the services provided. It is the only source of funds to pay for the staff and resources other than the doctor or advanced practice provider.
Patients typically receive two bills at provider-based clinics – a professional fee and a facility fee:
- The professional fee only pays for the time the doctor or advanced practice provider spends with you.
- The facility fee pays for all other people and resources required for your care.
The facility fee pays for:
- Nursing assistants
- Behavioral health therapists
- Social workers
- Care managers
- Lab technicians and phlebotomists
- Housekeeping and environmental services staff
- Security guards
- Front desk and check-in staff
- Drugs and supplies
- Medical equipment (e.g., blood pressure machines)
- Integrated electronic medical record
- Furniture (e.g., exam tables, waiting room chairs)
- Maintenance of buildings
When you receive a single bill after visiting some freestanding locations, it combines charges for facility and professional fees into one bill. It includes both costs.
The state legislature is proposing a bill that would prohibit facility fees for some outpatient clinics, including preventive and telehealth services. This would leave virtually no reimbursement for care from our nurses and dedicated staff members in these clinics.
Some clinics would be unable to support staff members, and this could reduce patients’ access to important care including Pap and HIV tests, mammograms, diabetes screening, cancer screenings, virtual behavioral health and specialist appointments, and more.
For more information on the facility fee bill and this legislative session, please visit the Colorado Hospital Association.