Results from a recent survey of Urgent Care Association members show that many Urgent Care centers are experiencing stagnancy or a decrease in reimbursement rates from insurance companies.

Some report a significant decrease while others have experienced a slow drop. Reimbursement rates vary by insurer and even by state.

Members that did not see an overall change in reimbursement rates noted that the operational cost to run an Urgent Care center is increasing, and while insurers raise premium costs to patients, Urgent Care centers very seldom see a result of those increases.

“I would recommend that Urgent Care should fight to get their own set of E/M codes apart from primary care, so that the codes will better encompass the cost of the care that we provide,” one anonymous member stated. “It seems that we are often undervalued because of our use of primary care E/M codes.”

This small snapshot into reimbursement issues is predictive of the future issues we will face. In the same vein as the sentiment above, we will continue to see an issue with reimbursement if we don’t require a National Certification Standard. As we have in the past, we need to continue to pave our own path, advocating for fair payment and implementing our own plan before we face external imposition. Being able to say we are Certified Urgent Care centers and consistently adhering to these quality standards will position us as a true specialty in the eyes of the key decision makers who affect our reimbursement.