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Hospitals Are Adding “Facility Fees” to Routine Visits By Teri Monroe, We once knew the basic rules of medical billing. You went to the hospital and paid for the room. You went to the doctor and paid for their time. In 2026, those lines have been deliberately erased. Hospital systems are aggressively acquiring independent physician practices. They are legally permitted to flip the signage on the door. Your local family practice is now a “Hospital Outpatient Department.” This administrative trick allows them to charge two bills for one visit. You pay the standard “Professional Fee” for the doctor. You also pay a hidden facility fee for walking into the room. This cover charge can range from $150 to $500 for a routine checkup. These fees often fall under your high deductible rather than your flat office copay. Here are the ways hospitals are adding these fees to your routine care this year. The most common trap is now at your specialist’s office. You might see a cardiologist at the same location you have visited for years. But a local hospital system bought the practice last month. It is now designated as “Provider-Based.” You receive a bill for the doctor’s time plus a separate facility charge. This fee can exceed $200 for the “clinic visit.” You often won’t know this happened until the bill arrives. The only warning sign might be a small plaque on the wall. It states the location is a department of the hospital. Facility fees have gone virtual in 2026. Your doctor may work for a large health system. They bill your video call as if it “originated” from the hospital main campus. You may see a line item for an “Originating Site Facility Fee” on your bill. The CMS rate for this fee is roughly $31.85, but private plans charge more. This adds cost to a call