Q: I have experienced a recent rash of missed appointments and I am hoping there is a code to bill for these missed appointments.

A: Unfortunately there is no CPT code for "missed appointment." It is not a billable or reimbursable service (or nonservice, 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, have strict policies on missed appointments and will charge patients when they miss an appointment, or at least do not notify or reschedule within 24 hours. The fear of the charge generally will influence a patient to show up for the appointment or, at the very least, contact the office in a timely fashion to avoid being charged. The latter is, in reality, what most offices would prefer so they can have the ability to schedule another patient for that particular 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. Ideally, the policy should be posted in a conspicuous place, available for patients to read at the time or, at minimum, given to them verbally. This should be part of office protocol and followed in the same manner with each patient so the office can ensure that patients were clearly informed and cannot later state they were not aware of the policy. Note the burden of proof 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 that the fees for missed appointment are typically a minimum of $20 to $25, not the full price of the services that would have been provided), but that they simply want the patient to respect the professional status of the services and the office.

Many offices are elastic in implementing this type of policy and may even forgive payment for those patients who have a valid excuse or other issues that were precedent. A patient who has had the fee forgiven may be more respectful and feel a greater sense of obligation to the office in the future. Although 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 the situation further.

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