Camille Johnson of Brooklyn, New York, revealed that her younger sister, who was seeking treatment for a rare health condition, received an itemized bill containing a $40 charge labeled as a “brief emotional/behavioral assessment.” According to Johnson, the charge was added simply because her sister shed tears during the consultation, without any accompanying mental health evaluation or support.
“One tear in and they charged her $40 without addressing why she is crying, trying to help, doing any evaluation, any prescription, nothing,” Johnson shared on Twitter, where her post quickly gained traction.
The charge corresponds to CPT code 96127, which is meant to cover standardized emotional or behavioral assessments, including screenings for depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD). While these assessments are mandated as essential benefits under the Affordable Care Act (ACA), Johnson maintains no such evaluation took place during her sister’s visit.
Healthcare billing experts point to the opacity of hospital “chargemasters” – comprehensive lists of billable services and their prices – as a key factor in unexpected medical charges. These lists are rarely accessible to patients before treatment, contributing to billing surprises and growing mistrust in the healthcare system.
The incident has prompted thousands to share their own experiences with unexpected medical charges. One patient reported being billed $1,902 for a pregnancy test labeled as “Women’s services,” while another described a $44 charge for “skin-to-skin contact” immediately following childbirth.
A 2020 study published in JAMA found that unexpected medical bills are far from rare – one in five insured adults in the United States received surprise bills from out-of-network providers within a two-year period. The study underscores the systemic nature of the problem.
“I got charged over $2,000 for an emergency room trip for a nosebleed that wouldn’t stop,” shared one social media user. “I had to wait so long, the nurse moved me into a room because I was bleeding all over the waiting room. Doc never saw me; it stopped bleeding before he arrived.”
The implications of such billing practices extend beyond financial impact. Research published in the Journal of Medical Internet Research indicates that despite mandates for hospitals to publish pricing information, the data is often presented in formats that make it difficult for patients to understand or use effectively.
Medical debt remains a leading cause of bankruptcy in the United States, and experts warn that fear of unexpected charges may cause patients to delay or avoid necessary medical care. This hesitation can lead to worse health outcomes and higher long-term healthcare costs.
“We need a drastic change in the healthcare industry,” Johnson emphasized, explaining her decision to share her sister’s experience. “I thought that sharing a real-life story online would be a good way to open up the conversation and help advocate for change.”
Healthcare policy experts note that addressing these challenges requires systemic changes to promote transparency and rebuild trust between patients and healthcare providers. Implementing clear, accessible billing practices and ensuring patients are informed about potential costs upfront are considered essential steps toward a more equitable healthcare system.
Editor’s Note: This article draws from social media posts, published medical research in JAMA and the Journal of Medical Internet Research, and healthcare policy documents.