Ask Christina: What Is the ‘Urgent Care Facility Fee’ on My Bill?

Health, Managing Medical Bills
Ask Christina

By NerdWallet Health health finance expert Christina LaMontagne

Question:

I recently had to go to an urgent care clinic with a severe sore throat. Afterward, I received two statements from my health insurance company. One seemed to be for the office visit and included my $50 copayment. The other showed lab charges for the strep and mononucleosis tests I received while there, as well as an “urgent care facility” fee of about $200 that went toward my deductible. When I called the hospital that oversees the clinic, they couldn’t explain to me what this fee was.

Answer:

Urgent care clinics are often a good alternative for people who need medical care when their primary doctor’s office is closed or can’t fit them in. Though they’re cheaper than visiting the emergency room, urgent care facilities may charge a facility or clinic fee like the one you see on your Explanation of Benefits. This flat fee covers the overhead costs of operation in an urgent care facility—things like utilities, staff and equipment.

A facilities fee of about $200 is not unusual. Though it may seem excessive, urgent care clinics are considerably cheaper than visiting the emergency room, often your only other choice. An NIH-funded study in 2013 found emergency room visits for upper respiratory infections cost $740 on average, likely at least a few hundred more than your total urgent care bill.

Going forward, you can save on urgent care visits by making sure your insurance will cover the costs incurred, comparing prices at various urgent care clinics, checking your bills for errors and possibly working with a medical bill advocate when you feel you are being overcharged.

While urgent care visits are not the most affordable option, doctor’s offices can’t always accommodate last-minute appointments or after-hours care. In these cases, they remain a smart choice.