What BC clinics can charge patients: MSP services, uninsured services and block fees

Clinics cannot charge for MSP-insured services

If a service is covered by MSP, the clinic cannot bill the patient extra for it. The BC government's page names items that may not be charged: supplies such as gowns, tongue depressors and urine test strips, "rental" fees for equipment the doctor uses, tray fees, and facility fees. ^[1]

The College of Physicians and Surgeons of BC (CPSBC) also has a practice standard on charging for uninsured services, and it starts from the same rule: insured services are not billed to patients. ^[2][3]

Uninsured services can be charged

Services and items that MSP does not cover can be charged for. Common examples are sick notes, insurance company forms, driver medical exams, and certificates required by a camp or employer, as well as supplies such as crutches, braces and fibreglass casts, and drugs such as allergy shots. ^[2][3]

The patient must be told the amount before the charge is made and must agree to it. A price list posted at the front desk does not count as telling the patient in advance. ^[2][3]

Suggested fees for 2026

Doctors of BC publishes suggested fees for uninsured services each year. The table shows some items from April 2026. These are suggestions only, so actual fees differ between clinics; if a fee is far off, it is reasonable to ask the clinic why. Rely on the clinic's written quote and the association's latest document. ^[4][5]

Separately, since November 2025 an employer in BC cannot ask for a doctor's note for the first two sick leaves of up to five days each in a year. ^[6]

Block fees are optional

Some clinics offer an annual block fee to cover uninsured items. It has to be voluntary, and a few limits apply: ^[2][3]

• If you do not pay, the doctor must still treat you
• A clinic cannot refuse a new patient because they will not pay the fee
• You can change your mind within one week of paying, and the clinic should refund you
• A block fee can cover one year at most

Missed-appointment fees and unpaid bills

A missed-appointment fee can be charged only if the clinic told the patient its policy beforehand. The 2026 suggested amount is $97.20, and the clinic should also offer a way to cancel an appointment. ^[4][2]

If a patient owes the clinic money, the doctor cannot refuse necessary treatment for that reason. ^[2]

If you think you were overcharged

1. Check whether the item is MSP-insured and whether the amount was stated before the charge.
2. If you were charged for an MSP-insured service, you can ask Health Insurance BC (HIBC) to investigate: 604-683-7151 in the Lower Mainland, and the form is found by searching "extra billing" on the BC government site. ^[1]
3. If your concern is about the doctor's conduct, complain to CPSBC. ^[3]