Billing of medical advice messages in MyChart
MyChart Patient Portal is an easy and convenient way to stay in touch with your care team. Over the past few years, MyChart has also become another way to seek medical advice, rather than coming in for an appointment. This has resulted in a significant increase in the number of messages our providers receive.
As of June 27, 2023, you will see a notification that you may be billed for medical advice messages. To account for the medical advice and expertise provided through MyChart, UW Medicine will bill for some of these medical advice responses that provide care or consultation that otherwise would have been done through a clinic or telemedicine appointment. These medical advice messages enable you to receive care via MyChart without making an appointment for every care need. This change applies to patients at Fred Hutchinson Cancer Center as well.
Frequently asked questions
What MyChart messages will be billed
While most MyChart messages will remain free, replies that require medical expertise and more than five minutes of your provider’s time may be billed, as we do for other medical services. If a MyChart message is billable, we will first bill your insurance provider, as we do for all other medical services.
Messages that WILL NOT be billed
You will not be billed for the following types of MyChart messages:
- Scheduling an appointment
- Requesting a prescription refill
- Questions that lead to an appointment
- Questions related to a visit you had in the last seven days
- Questions about billing
- Messages that take less than five minutes of your clinician’s time to answer
- Messages initiated by your healthcare team
Messages that MAY be billed
Examples of types of messages that may be billed include:
- Requests for new medications
- Questions about new symptoms or problems
- Questions about news or journal articles
- Changes to a chronic condition
- Requests to fill out medical forms
- Requests for new referrals
How MyChart messages are billed
If a MyChart message is billable, we will first bill your insurance provider, as we do for other medical services. These messages can be viewed as a kind of virtual consultation, similar to an in-person appointment. If a MyChart message incurs a charge, it will be billed as we do for other medical services.
Cost of billed MyChart messages
Anticipated costs vary based on insurance coverage and are subject to change periodically:
- Medicare: $14-$52
- Medicaid: $7-$28
- Private Insurance: Most private insurance carriers cover this at little to no cost to patients. If covered, copays, co-insurance, and/or deductibles may apply.
- No Insurance or Not Covered by Insurance: $27-$98
Financial assistance applies to MyChart medical advice message charges.
Depending on your insurer, the costs may be covered at 100% or you may receive a bill which may represent a copay, coinsurance and/or deductible. Contact your insurer to learn your out-of-pocket cost for a medical advice message. If the insurer asks for a “CPT code”, the codes typically used are 99421, 99422 and 99423.
If you do not have insurance or the service is not covered by insurance, you will receive a bill which may include a 30% discount if eligible.If you need help paying your bill, whether you have insurance or not, you may qualify for financial assistance. For more information about financial assistance:
- UW Medicine patients: Visit UW Medicine Billing and Insurance or contact Patient Accounts & Support Services by calling 206.520.0400 or 1.855.520.0400.
- Fred Hutchinson Cancer Center patients: Call 206.606.6226 (option 1) or submit questions via MyChart.
Why are there different costs for MyChart messages?
As with any in-person appointment or medical service, costs can vary depending on the amount and level of expertise required to ensure the best possible treatment and patient outcome, as well as each patient’s insurance coverage.
Financial assistance for MyChart messages
Does UW Medicine financial assistance apply to MyChart message billing?
Yes. Financial assistance applies to professional fees, including medical advice MyChart messages. Your gross income must fall within 0-300% of the Federal Poverty Level for financial assistance to apply to full coverage of out-of-pocket costs. If you have questions about your specific situation, you can request more information by calling 206.744.3084 or visit UW Medicine Financial Assistance.
How do I know if I qualify for financial assistance?
UW Medicine provides financial assistance for eligible patients based on gross family income. More information and the financial assistance application is available at UW Medicine Financial Assistance.
Are Fred Hutchinson Cancer Center patients affected?
Yes, this change in billing affects all patients using MyChart, including those receiving care at Fred Hutch. Fred Hutch patients who have questions may call 206.606.6226 (option 1) or submit questions via MyChart.
Additional billing questions
Will I be billed if my clinician sends me a MyChart message on a new topic (not a response to a message I sent)?
No, patients will only be billed for medical advice messages that they initiate. If your clinician sends you a message asking for information or giving you an update on a topic you didn’t start, you won’t be billed.
Will I be billed for referral requests for support services that are related to an existing treatment plan?
Requests for referrals to support services (e.g. physical therapy, nutrition services, etc.) that are related to an existing treatment plan, such as ongoing cancer treatment, are not considered “new” referral requests, generally take less than 5 minutes of a clinician’s time and would not billed.