Claire Galt
•9/14/2026
SOUTHWEST FLORIDA, (WINK) — Your copay may not be the only charge you face when you visit some Lee Health doctors.
Two women who came to a WINK Listens event in Estero told WINK News they have been charged additional “facility fees” at Lee Health offices designated as hospital outpatient departments, or HODs.
Their concern is not simply that the fees exist. They question whether patients are being clearly told about them before an appointment.
Cathy Kaiser said she received a facility fee after visiting the same doctor she had been seeing for years.
“The same doctor I've been going to for 10 years, the same building, the same office, the same examining room,” Kaiser said. “But now all of a sudden, I incur a facility fee.”
Kaiser said she paid her regular copay and later received another bill for $59.
“My fight today is not so much the extra $59 over and above my copay. Is the lack of transparency?” Kaiser said.
HOD stands for hospital outpatient department.
Lee Health told WINK News some outpatient locations carry that designation even when they are not physically located on a hospital campus. The health system said those locations must meet additional hospital-level standards for staffing, equipment, technology, safety and compliance, which can mean higher costs.
Depending on a patient’s insurance, that can mean a separate facility charge in addition to what they pay to see the doctor.
Lee Health also told WINK News that signage is posted at off-campus HOD locations to notify patients that a facility fee may apply.
So WINK News went to the Lee Health Adult Endocrinology office on Colonial Center Drive in Fort Myers, where Kaiser said she incurred the charge.
WINK News did not see an HOD notice posted.
When WINK News asked staff where the notice was, an employee retrieved the sign from a drawer.
WINK News called the Lee Health spokesperson back. The spokesperson said the HOD offices had been instructed to have the sign posted.
After the visit, the spokesperson sent WINK News photos showing HOD notices now posted outside that same office.
Lee Health also directed WINK News to its billing website, where it lists locations where a facility fee may be charged.
Kaiser said that still leaves a problem for patients who do not know what an HOD is or know to look for that list.
Another woman, Judy Porsavage, said she called Lee Health billing after seeing an earlier WINK Listens story about another patient whose facility fee had been excused.
“So I figured if it worked for that Judy, it might work for this Judy,” Porsavage said.
Porsavage said Lee Health then excused her $59.13 charge as a one-time exception.
She said the possibility of paying another facility fee has also changed where she gets care.
“I stopped going to the neurologist because I can't afford to be paying my copay is $45 plus 59,” Porsavage said. “I can't afford to be going to doctors with that kind of cost involved.”
Lee Health said it is committed to transparency and helping patients understand their financial responsibility before receiving care. The health system also said patients with billing questions or concerns can contact its financial team.
For Kaiser and Porsavage, the issue is simple: they want to know about the extra cost before the appointment, not after the bill arrives.
