Ask The Expert: Charging for Missed Appointments

Question: I have had recent rash of patients missing appointments and I am hoping there is code to bill for these missed appointments?

Answer: Unfortunately there is no CPT code for “missed appointment.” It is not a billable or reimbursable service (or non-service, as it were) from any insurance carrier. However, an office is not precluded from billing a patient for a missed appointment. In fact, charges for missed appointments are very common among all health care professionals. Dentists, in particular, typically have strict policies on missed appointments and will charge patients when they miss or at least do not notify or reschedule within 24 hours of the appointment. Policies like this are more common than uncommon. The fear of the charge generally will influence a patient to not miss the appointment or, at the very least, contact the office timely to avoid being charged. The latter is in reality what most offices would prefer as they have the ability to schedule another patient for that time.

If you wish to start implementing a missed appointment fee there are few things that should be done to avoid confusion and misunderstanding. Patients must be informed at the time they schedule the appointment that there is a specific policy about missed appointments. It would be best for it to be posted in a conspicuous place, available to read at the time, or, at minimum, given verbally. This should be part of office protocol and followed in the same manner with each patient so the office can ensure that the patient was clearly informed and cannot later state they were not “aware.” Note the burden of proof that the patient was made aware is on the creditor (doctor). This would include costs and what constitutes a missed appointment, such as less than 24 hours’ notice.

Remember, it is not so much that the doctor wants the fee (note the fees for missed appointment are minimal $20-25 typically, and not at the full price of the services that would have been provided) but simply wants the patient to respect the professional status of the services and the office.

Many offices are elastic in implementing the policy and may even forgive payment for those patients who have a valid excuse or other issues that were precedent. A patient whom has had the fee forgiven may likely be more respectful after a favor has been afforded and feel a greater sense of obligation to the office in the future. Though it could go the other way, it is best to remember why the policy is there: not to collect a fee but to ensure compliance. If a patient does not comply, at least we know to not schedule them and exacerbate it further.