Nursing Blogs

Patient Charged $11 for “Brief Emotion” During Surgery


Getting care can be emotional. You’ve probably seen dozens of patients tear up at the hospital as they get ready to go under the knife.

A woman in the U.S. recently tweeted that a hospital allegedly charged her extra for “crying during a procedure”. She posted a photo of the bill to Twitter, where it quickly went viral. The line item says “Brief Emotion” along with an $11 charge and a small discount of $2.20.

Charging for Emotions

Twitter user @mxmclain, whose real name is Midge, posted a picture of an invoice from her insurance company after getting her mole removed at a local hospital. The procedure was billed as “Physician Ser.” along with an $11 dollar charge for “Brief Emotion”. The entire experience ended up costing her $234.06.

For the caption, she tweeted: “Crying: Extra.”

She joked that she didn’t even get a “damn sticker” and whether a lollipop was too much to ask.

It didn’t take long for the tweet to go viral as thousands of people started sharing and commenting on the post. Some responded by sharing their own experiences in the hospital, while others drew comparisons to Aerosmith’s “Sweet Emotions”.

One Twitter user asked, “Was the $2 discount for crying pretty?”

Another user questioned, “Does your healthcare cover feelings?”

“How did they come to that amount I wonder. Pennies per tear?” wrote a third.

People used the experience to call out the American healthcare system for trying to make a profit.

But her tweet doesn’t tell the full story.

Experts say she wasn’t charged for crying during the procedure. “Brief Emotion” is code for brief behavioral assessment, using the CPT code 96127. It’s a routine mental health screening that’s a part of the clinical intake process.

During the initial assessment, the provider likely asked Midge how she was feeling. Midge answered the questions not realizing that this short Q&A was another service she would have to pay for.

Patients say they have a right to know how and why they’re being charged.

Critics say some doctors genuinely want to know how the patient is feeling before starting the procedure, but others are just trying to earn a profit.

Eleven dollars may not seem like a lot, but these charges can add up. The healthcare industry is full of small charges that amount to millions of dollars in revenue every year.

According to a company called Mentegram, which provides screening software to medical providers, “CPT Code 96127 may be billed four times for each patient per visit … not only will clinicians have more efficient practices by utilizing these screenings, but they can also use them to build revenue.”

Each screening only costs a few dollars, but providers can multiply that number by four.

“If a patient requires four different screenings, that will be $24 per patient per visit,” writes Mentegram. “Can you see how this missed income can really add up?”

Studies show most insurance companies cover the cost of a psychological assessment. However, many insurance plans require prior authorization for this service. Most plans also require that you meet your deductible, pay a co-pay, and/or pay co-insurance for the evaluation. The prior authorization is designed to make sure the assessment is medically necessary. 

Every plan is different, so patients should look at their insurance information before consenting to a behavioral assessment.

As for @mxmclain, she’s glad that providers are checking in on her mental health, but says, “if it’s so important it should be fully covered by insurance.”


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