Hospital Outpatient Billing at Newton-Wellesley

When your visit takes place in a hospital outpatient location, there will typically be two charges, which may result in you paying more for your visit than if you are seen in a physician office. Your out-of-pocket costs could include the following:

You will be charged for the physician’s examination, which will usually be covered by your co-payment.

You will also be charged by the hospital for use of hospital space, equipment, and support staff. This is commonly known as a “Facility Fee.” Your health plan may apply these hospital charges to your annual deductible, and after using up your deductible, you may be responsible for a co-insurance payment.

You may receive a bill that combines the charges from the hospital and the physician on one line, or these charges may be split into two lines, depending on the location. We will request your co-payment when you check in for your visit, and we will send you a bill for any unpaid balances after we receive payment from your insurance company.

Physician office visit vs. Hospital outpatient visit

You can find information about whether your visit is a physician office or hospital outpatient visit in notices in our waiting rooms and in electronic appointment reminded for your scheduled visits. 

Referral and prior authorization

For both physician office and hospital outpatient visits, your health insurer may require you to get a referral or authorization.  In addition, our providers may be considered "in network" or "out of network" depending on the specifics of your health insurance plan, which could affect the amount you pay. 

Billing for procedures performed during the visit

No matter the location, if a procedure is performed during the visit, you may have further out-of-pocket costs for additional physicians' services and for use of the hospital facilities and staff, even if the procedure was performed in the same exam room as the visit with the physician. Your health plan may apply these additional physician and hospital charges to your annual deductible, and after using up your deductible, you may be responsible for an additional co-insurance payment. 

Laboratory and imaging services

If your physician ordered laboratory tests or imaging services (such a X-ray, CY or MRI), you may be billed for these tests by the hospital, clinical laboratory, or imaging center, and you may also be billed for the services of the physicians (usually pathologists and radiologists) who interpreted the test results. 

How much will my visit cost?

It is your right to receive an estimate of the cost of your visit in advance of the visit. Please contact Mass General Brigham Patient Billing Solutions (see below) at least two business days prior to your visit to get an estimate.  Please have as many details as possible about your upcoming visit, including the provider name, location, and details of the planned service or procedure. 

Special notice for Medicare patients

If you are a Medicare beneficiary and your visit takes place in a hospital outpatient location, you will be responsible for a Medicare Part B out-of-pocket co-insurance payment of approximately $25 for the hospital facility charge. Procedure charges or other testing could increase your out-of-pocket expense. 

Please contact the Member Services department of your health insurance plan to verify your coverage and financial responsibility for services described on this page. This phone number is usually located on your insurance card. 

Contact Mass General Brigham Patient Billing Solutions: 

Mailing Address:
Patient Billing Solutions
Mass General Brigham
399 Revolution Drive
Somerville, MA 02145

Phone: 617-726-3884
Monday- Friday, 9:00 AM to 4:30 PM

Email: patientbilling@partners.org

Mass General Brigham billing and insurance