Member Q&A: No-Show and Late Cancellation Fee Policies - 7/1/2026
OfflineJohns Hopkins Community Physicians asks: Does your medical group charge no show and late cancellation fees? If so, what is the range of the fees? If yes, do you place credit cards on file for certain services, e.g., behavioral health services? What are your best practices or lessons learned?
Submitted by:
Kathryn A. Waldeisen
Executive Director, Strategy
Johns Hopkins Community Physicians
Member Responses
Prohealth Physicians – Part of OptumCare
Cristina Friedman
Senior Regional Director of Operations
We do not routinely charge a no-show fee unless it is a repeat occurrence. When confirming appointments, we advise patients: "Please call to cancel at least 24 hours prior to your appointment; otherwise, you may be charged a $25 no-show fee." While we do not consistently assess the fee—and Medicaid patients cannot be charged—we find that clearly communicating the policy helps reduce no-shows.
One best practice across our Internal Medicine practices is proactively reviewing schedules at least one week in advance, along with daily reviews of upcoming appointments. We prioritize outreach and confirmation calls for:
- Patients with a history of no-shows
- Patients who have not completed MyChart eCheck-In
- Patients with outstanding balances
This approach has improved appointment adherence and reduces last-minute gaps in the schedule.
We also implemented an EPIC update that allows for clearer allocation between overbook and open slots. Previously, high no-show patients often filled open slots, requiring teams to wait before placing another patient into an overbook. With this update, teams can proactively move those patients into overbook slots, preserving open appointments for MyChart availability and the call center.
We had our fee structure reviewed by our revenue cycle team previously. Currently, non-surgical appointments are $25, while surgical specialties are a bit higher.
For appointment confirmations, we use a mix of methods based on patient preferences in our system (e.g., text, email, automated outreach). For higher-risk patients—such as those with a history of no-shows, incomplete eCheck-ins, or outstanding balances—we prioritize direct phone outreach.
St. Charles Health System
Jessica Petkovic, MHA
Administrative Director of Primary Care
japetkovic@stcharleshealthcare.org
We've seen a significant increase in late cancellations this year, and it's having a substantial impact on our Primary Care practices. We currently define a late cancellation as one made within 24 hours of the scheduled appointment.
We haven't made any decisions yet and are still evaluating potential next steps. One option we've discussed is starting with high-demand procedures, such as colonoscopies, where late cancellation rates can reach 30%. With only one day's notice, it's often not possible to fill those procedure slots, resulting in lost access and unused capacity.
Some ideas we've considered include requiring an upfront deposit for the procedure or charging a late cancellation fee of approximately $30, which appears to be in line with practices at other organizations in Oregon.
I'd be interested in hearing what others are doing and whether you've found any approaches to be particularly effective.
Duke Primary Care
Kevin Shah, MD, MBA
Vice President, Duke University Health System
Chief Medical Officer, Duke Primary Care
Associate Professor of Medicine
There is no charge for missed appointments/no-show fees and there are no plans to implement them. There is a policy that allows for patient discharge after multiple no-shows; however, this is used very infrequently.
Community Physicians Group
Julie A, O'Toole-Black
Vice President, Access & Operations
Community Physician Group does not currently charge for no shows or impose late cancellation fees, though we are exploring the option. More than 15 years ago we did charge a nominal no show fee of $25, but because payers didn’t reimburse the fee, and we had difficulty collecting from patients, we found it cost prohibitive to administer and stopped. We have started to encourage collection of credit cards on file, with approval of up to $200 in charges. This has been met with mixed support from our patients. We’d also be interested in learning what others are doing in this space and hear of best practice approaches that are proving successful.
Northwestern Health Network Medical Group
Jennifer Andersson MBA, BSN, RN
Vice President Operations
We do not collect no-show fees at Northwestern Medicine, but our physicians continually ask about it and I’m curious if there are other organizations who do collect no-show fees. We understand it to be extremely burdensome and were told that collecting the fees would fall upon our Practice Administrators to administer.
Sutter Medical Group
Michael Conroy, MD
President & CEO
Michael.Conroy@sutterhealth.org
Sutter Health does not charge late cancellation or no-show fees.
Health Partners
Kendall Johnson
Quality Director
Kendall.C.Johnson2@healthpartners.com
Behavioral Health stopped charging for no shows during/after the pandemic. They will restrict scheduling after a set number of no shows if appropriate.
Health Partners
Amber Larson
Senior Director, Medical Specialties & Quality Improvement
Amber.R.Larson@healthpartners.com
It has been a longstanding wish for many medical specialties to do this, but my understanding is we believe it’s not community standard so we don’t want to create barriers to accessing care.
0 Conclusions