Facility fees: How to fight this hidden cost of healthcare

Facility fees: How to fight this hidden cost of healthcare

If you’ve been to a medical visit lately and ended up with two bills — one from your healthcare professional and a second one, unexpectedly, from the facility — you’re not alone. Healthcare facilities’ fees are catching many consumers by surprise.

Facility fees aren’t new, but they are receiving a new level of scrutiny from consumers, advocacy groups, media outlets, and lawmakers. These charges are also becoming more common for many reasons, such as hospital systems buying private practices.

Understanding facility fees can help you make more informed choices about your care. Here, GoodRx, a platform for medication savings, covers what facility fees are, what they cost, how they’re being explained, and what some people are doing to get rid of them.

Key takeaways:

• Facility fees are charges from hospital systems that cover overhead costs. They’re separate from what your healthcare professional charges and can show up even for outpatient or virtual visits.
• These fees are becoming more common and costly. Insurance often doesn’t cover facility fees, and even if yours does, you may still owe out of pocket if you haven’t met your deductible.

You may be able to dispute a facility fee and have it removed from your medical bill. Lawmakers are also working to limit facility fees.

What are facility fees?

A facility fee is a charge that helps a medical location cover overhead costs such as building maintenance, equipment, and staff members who may not provide care directly but are essential. A facility fee does not cover your healthcare professional’s services. It might show up on your bill as a “clinic fee,” “provider-based billing,” or “hospital outpatient payment” — the preferred term for many hospital associations and advocacy groups.

Previously, these types of fees were typically charged for inpatient hospital stays. Now, they’re common for nonhospital visits and even virtual care from healthcare professionals who work for a hospital system. That means you could see a facility fee on your medical bill when visiting:

• Ambulatory surgical centers (same-day or outpatient surgery centers)
• Freestanding emergency rooms
• Urgent care centers
• Diagnostic imaging or testing centers
• Hospital-owned medical facilities

How are facility fees different from other fees?

Facility fees are different from copays and coinsurance. Those are amounts you pay based on your health plan’s cost-sharing rules. Facility fees are also separate from physician fees, which cover care provided directly by healthcare professionals.

What specific expenses do facility fees cover?

Facility fees help pay for the resources a hospital or health system needs to provide care for all patients. They help cover a wide range of costs that keep the facility running day to day — and often 24 hours a day — including the following,

• Medical and support personnel: nurses, nursing assistants, lab techs, pharmacists, custodians, and security staff.
• Facility operations: building maintenance and safety, utilities, IT systems, licensing, and accreditation.
• Medical equipment: technology, supplies, furniture, and what’s needed for specialized programs such as trauma services and cancer treatment.

How can I avoid facility fees?

Here are some ways you may be able to sidestep a facility fee:

• Good faith estimates in healthcare: If you’re uninsured or paying cash for your medical care, healthcare professionals and facilities can give you cost estimates for services in advance.
• Direct primary care (DPC) may help you avoid facility fees. DPC practices charge flat fees for routine healthcare appointments, typically don’t accept insurance, and usually aren’t tied to hospitals.
• Medical bills aren’t always final. You may be able to negotiate charges with your healthcare professional, medical facility, or insurance plan.
   

Why do some hospitals charge facility fees?

Hospital associations and advocacy groups say facility fees help pay for parts of your care that go beyond what your healthcare professional provides. For many hospital systems, they’re the only source of revenue for:

• Staff salaries
• Building upkeep and facility infrastructure
• Hospital services and programs
   

Facility fees also help cover the extra costs of running outpatient clinics and medical offices. Hospitals say having these locations makes it easier for people to get appointments and access different types of care.

How much do facility fees typically cost?

Hospital facility fees for primary care and pediatric visits averaged about $100 in 2022, according to a Health Care Cost Institute report published in 2025. Though, there was a wide variation in fees between states. Here are some examples.

Facility fees can vary by hospital or medical office even within the same hospital system. Some consumers don’t pay facility fees, while others receive charges in the thousands. And there’s not always a clear link between facility fees and the care provided, which makes them hard to predict and even harder to estimate. That’s why it’s important to ask about facility fees ahead of time.

Will insurance cover facility fees?

Some insurance plans cover outpatient facility fees in part or in full, but others don’t pay them at all. Some plans will cover facility fees in certain situations, such as for inpatient hospital stays. Check with your plan to see if and how facility fees are covered.

Even if your plan does cover facility fees, you might still have to pay if you haven’t met your annual deductible. After you’ve met your deductible, you could still owe part of the fee under your plan’s cost-sharing rules. If your health plan pays only part of the cost, the facility may bill you for the rest.

How do facility fees affect consumers?

Facility fees can strain finances and lead people to avoid needed care. Here’s how.

Higher price for the same care

You might pay more for a routine visit than you’ve paid before, simply because a hospital now owns your healthcare professional’s office. With facility fees, the care doesn’t change, but the price does.

Delayed or skipped care

With an ER visit, for instance, a facility fee can contribute to 80% of the bill, which is typically the share for items and services other than a doctor’s care. People may delay or skip emergency care for fear of a high medical bill.

More medical debt

Some consumers take on debt to get needed care, while others are surprised by charges. Facility fees aren’t always an expected part of healthcare bills, which makes it harder to plan for costs and can add to medical debt.

Can you fight facility fees?

Yes, you can challenge a facility fee. Your efforts may result in the charge being removed or reduced.

If you have insurance, start by reviewing your health plan’s summary of benefits and coverage to see if facility fees are included. If you’re responsible for the fee, try these steps:

• Request an itemized bill. Review the charges and ask the hospital’s billing office to reduce or remove the fee. See if they offer discounts, such as for paying the bill in full.
• Check with your insurance plan. Ask if they can cover the facility fee or negotiate an amended charge for you.
• Reach out to a patient advocate. Some states offer free advocacy services that may help you get the facility fee reduced or waived.
• File a complaint. You can contact the Consumer Financial Protection Bureau or your state attorney general’s office for help.

Stay in touch with the hospital system’s billing department while disputing the charge. Open communication may help keep your unpaid bill out of collections.

What are lawmakers doing to address facility fees?

Lawmakers at both the state and federal levels are taking steps to control facility fees. As of July 2025, 19 states had passed laws to address these charges.

Many of these laws limit or ban facility fees for certain outpatient services and require greater transparency and awareness around when and why hospitals charge them.

Federal policymakers are also proposing changes to Medicare payments, so that the same service is reimbursed at the same rate, no matter where it’s provided. This could create a standard Medicare facility fee schedule or even eliminate the fee entirely across healthcare settings. Medicare has also started incorporating facility fees into its procedure price lookup tool.

Can hospitals and other healthcare facilities sustain their services without facility fees?

Many hospital systems say facility fees cover the true cost of care and are essential to keep services running, especially in rural or lower-income areas.

In a 2023 Texas Hospital Association member survey, nearly 70% of responders said they would close if facility fees were banned. Up to 85% would reportedly need to cut staff or reduce services without the revenue generated by these charges.

The bottom line

Facility fees are charges that hospitals and other medical settings add to help cover their overhead costs. These fees are showing up more often, including for routine visits and virtual care. Hospital officials say facility fees fund the infrastructure needed to keep medical services running. But for consumers, the lack of transparency and cost is leading to confusion, frustration, and debt.

Several states have passed laws to limit facility fees and add transparency to these charges. Just knowing that you may be charged a facility fee — and why — can help you make more informed choices about your healthcare and finances.

This story was produced by GoodRx and reviewed and distributed by Stacker.