We used to book medical appointments with a simple phone call. You gave your name and showed up on time. That trust-based system has collapsed in 2026. Practices lose billions annually to last-minute cancellations. They have responded by erecting financial barriers. You must now pay to secure your spot on the calendar.
This “pay-to-book” model has expanded beyond plastic surgery. It now affects routine healthcare for seniors. Offices require a credit card on file before scheduling. They charge a “holding fee” ranging from $50 to $500. This money is often forfeited if you reschedule late. Here are seven appointments that now demand cash upfront.
1. New Patient Dermatology Exams
Skin doctors are the hardest specialists to see. Wait times often exceed six months. Practices now charge a booking deposit to filter out casual bookings. You might pay $100 just to hold the date. This applies even for routine mole checks. The fee is deducted from your final bill. If you cancel within 48 hours, the money is gone.
2. Psychiatric Intake Evaluations
Mental health demand remains at record highs. Psychiatrists face high no-show rates for initial visits. Many now require a full session deposit to book an intake. This can cost $300 or more. Insurance rarely reimburses this if you do not attend. You are essentially paying for the doctor’s time in advance.
3. Advanced MRI Scans
Hospitals are cracking down on bad debt. Imaging centers now demand upfront payment for your estimated deductible. They run your insurance before you arrive. If you have a $500 deductible, they want it paid before the scan. They will not reserve the machine without this payment. This turns a medical test into a prepaid transaction.
4. Fertility Consultations
IVF clinics have always been expensive. Now the initial conversation costs money too. Clinics charge consultation retainers to speak with a specialist. This prevents “window shoppers” from filling the schedule. The fee ensures the patient is serious about treatment. These fees are almost never covered by insurance.
5. Cosmetic Dentistry Assessments
Your dentist might fix cavities for a copay. Implants and veneers are different. Dentists now require deposits for major procedure consultations. They block out hours for these assessments. A $200 deposit protects their revenue if you ghost them. This is standard for any work deemed “elective.”
6. Concierge Medicine Meet-and-Greets
Many primary care doctors are switching to subscription models. They charge a fee just to interview them. You pay a non-refundable deposit to see if you like the practice. This fee does not apply to your future membership. It is simply an access fee. It limits the pool of potential patients to serious buyers.
7. Physical Therapy Evaluations
High-volume clinics are protecting their schedules. An initial evaluation takes 45 minutes of a therapist’s time. Clinics now charge a reservation fee for this first slot. This reduces the risk of new patients skipping the appointment. Regular sessions may not require this. The initial intake almost always does.
Read the Cancellation Policy
You are handing over real money before seeing a doctor. Read the fine print on the refund policy. Ask exactly how many hours notice is required to get your money back. Document the name of the person you pay. In 2026, a “forgotten” appointment is an expensive mistake.
Did you have to pay $50 just to make an appointment? Leave a comment below—tell us which doctor asked for a deposit!
You May Also Like…
- 6 Medicare Network Changes That Only Appear After Appointments Are Scheduled
- Medical Clinics Are Quietly Shortening Appointment Windows in January
- 7 Medical Services That Lost Full Coverage This Quarter
- 5 Ways Insurance Changes Hit Fixed-Income Households
- Medical Appointment Availability Is Shrinking for Non-Urgent Care
Read the full article here
