To Fee or not to Fee? That is the Question

No-shows. Schedule skippers. Patients missing in action.

No practice likes them, but all practices have them.

One solution? Charging a missed appointment fee. But there are some pros and cons to weigh before implementing one. And a strategy behind it.


  1. It offers a tangible reason for patients not to skip—or to at least call ahead to cancel
  2. It can make up a small amount of lost revenue from missed appointments
  3. It shows patients that missing an appointment without a call isn’t acceptable


  1. It can make your practice seem inflexible and more about profit than patients
  2. It can turn missed appointment into a lost patient
  3. It can lead to negative word-of-mouth or online reviews

If you do decide your problem with now shows is big enough to charge a fee, here are some things to keep in mind to maintain strong relationship with your patients in the process.

  1. Be transparent—tell patients that your practice takes missed appointments seriously because they leave people without work and that you have a no-show fee policy in place. Have something printed that can be sent home with the patient. Or better yet a police to sign. The fee should never be a surprise.
  2. Be proactive—call, text, or email the patient reminders. Often missed appointments are forgotten appointments. And if they were scheduled well in advance you can’t really blame a busy patient for forgetting. A little reminder can make a huge difference.
  3. Be understanding—perhaps don’t charge for the first missed appointment or start with a small fee and only increase it if skipping appointments seems to become a habit. Allow patients to state their case if they believe the fee is unfair (perhaps they had a family emergency). At the end of the day you need to show your patients that a fee doesn’t mean you don’t care.