Words are cheap, but emotion will cost you. An American woman recently found that out the hard way when she went in for a routine medical checkup that included a mole removal, and ended up with a hefty invoice that included an $11 (£8) fee for “brief emotion”. The Virginia-based woman, who goes by the name Midge, or @mxmclain online, tweeted a copy of her invoice last week. “Mole removal: $223”, she said in the viral tweet. “Crying: extra.”
To be fair, @mxmclain didn’t get charged for crying. “Brief emotion” is short for brief emotional assessment. What happened was probably something like this: in the middle of Midge’s checkup, her healthcare provider wanted to ask her some routine questions about her mental state. “Can I ask you a few things?” her doctor might have said. “Of course,” Midge might have replied, as anyone would. She wouldn’t have realised this short Q&A was a service she was expected to pay extra for.
Eleven dollars isn’t an enormous amount of money. It’s the sort of fee that a busy person could easily overlook. But that is exactly what makes such a sum so insidious. The American healthcare system is full of charges like this. It’s full of small procedures that add up to enormous amounts. It’s full of unnecessary interventions that add up to millions of dollars.
A “brief emotional assessment” has a name: CPT code 96127. That’s the way in which health providers bill their questionnaires. Some doctors ask the questions because they genuinely want to know the answers. Others go through the assessment because it’s an easy way to pad their bills. Lest you think that I’m being cynical, let me point you to an online blog from a company called Mentegram that provides screening software to health providers. According to its online blog: “CPT Code 96127 may be billed four times for each patient per visit … not only will clinicians have more efficient practices by utilising these screenings, but they can also use them to build revenue.” Each assessment is only a few dollars, but that adds up. I have a brief emotion to describe all this: it’s best summed up as rage.
Arwa Mahdawi is a Guardian columnist