People hate Twitter for a lot of good reasons, but it undeniably rules when people post their insane medical bills and it goes viral. This week, a woman in New York tweeted about her sister’s bill, which ostensibly included “$40 for crying.”
The tweet was similar to another post that went viral last year: A person whose bill for a mole removal included $11 for “Brief emotion,” which the poster assumed was because she cried. She got $2.20 off, though.
The “Brief emotion” line in the second tweet is short for “brief emotional/behavioral assessment,” the same charge as in the first tweet, which falls under CPT code 96127. (You can just see the end of the code on the left column there.) The full definition is: “Brief emotional/behavioral assessment (e.g., depression inventory, attention-deficit/hyperactivity disorder [ADHD] scale), with scoring and documentation, per standardized instrument.” So neither patient was charged for crying, per se; they were charged for being screened for depression or other mental health problems. The American Academy of Family Physicians says that this code should only be used for “purely preventive” screening, not based on signs or symptoms—like crying in the doctor’s office, for example. Hmm!
Let’s back up—what the heck are CPT codes? Current Procedural Terminology (CPT) codes are an insane language of medical billing. They exist to assign value to every imaginable medical procedure and activity, from a physical exam to a circumcision. Providers use these codes to bill payers, like insurance companies or Medicare, or you, if you’re uninsured. Almost all medical care in the US is paid for with a fee-for-service model, which reimburses medical providers for care provided based on their activities, explaining why you get these bizarrely specific line items and inscrutable codes on your bill. These codes are extremely useful to know about if you ever want to challenge a medical bill, because you can easily find out how much Medicare reimburses providers for these billing codes using their Physician Fee Schedule search.