Medical bill fees and strange add-on charges

What extra medical fees and charges are you seeing in your medical bills?

Health care

Patients are frustrated when they find add-on fees on their medical bills.

Medical bills are expensive enough. But what are these new medical fees and charges we are seeing? 

People in the U.S. spend more on health care than any other developed nation: more than $12,000 per person

That’s a lot. And now there is a new troubling trend in medical billing: additional fees and charges that add to the “amount due” on our regular medical bills. These medical fees drive up costs above what we expect to pay. 

Have you received a bill that includes a strange add-on fee or charge? Tell us!

We’ve heard about some pretty upsetting medical fees. These charges are unconnected to an official “billing code” and often are not covered by insurance plans. That means patients are asked to pay these creative but costly charges themselves – and it’s likely those payments won’t count towards their annual deductible. 

Examples of medical fees:

  • Fees for Personal Protective Equipment (PPE) (like masks and gowns)
  • Room disinfection fees or cleaning fees
  • Fees to use your patient portal to get your lab tests results
  • Annual fees to stay on the “active patient” list of your primary care doctor, ob/gyn, or other specialist

Have you received a bill that includes a strange add-on fee or charge? Tell us!

We know medical bills are expensive and patients already have to pay co-pays and co-insurance, as well as pay for their annual deductible. The last thing we need are add-on charges that our insurance company won’t cover and that simply seem to be ways to drive more income to our health care professionals. 

We need to put an end to expensive, unjustified, uncovered charges. 

What used to be a fully-covered doctor’s appointment might now cost patients more than they can afford. And that’s bad public health policy. 

Nearly 2 in 5 patients delay seeking care because of cost, potentially worsening their medical conditions or missing life-saving screenings and preventive care appointments. 

If you have been charged an add-on fee or strange charge, tell us! We want to find more examples of charges to alert our state and federal officials. 

Let’s put an end to fees and charges tacked onto our medical bills.


Patricia Kelmar

Senior Director, Health Care Campaigns, U.S. PIRG Education Fund

Patricia directs the health care campaign work for U.S. PIRG and provides support to our state offices for state-based health initiatives. Her prior roles include senior policy advisor at NJ Health Care Quality Institute, associate state director at AARP New Jersey and consumer advocate at NJPIRG. She was appointed to the Ground Ambulance and Patient Billing Advisory Committee in 2022 and works with patient advocates across the U.S. Patricia enjoys walking along the Potomac River and sharing her love of books with friends and family around the world.

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