Viral Tweet Claiming Woman Got Charged $11 for Crying at Mole Removal Explained

A woman who posted a viral tweet suggesting she had been charged $11 for crying at a mole removal has revealed what the "brief emotion" fee really was.

Twitter user mxmclain posted a photo of her bill on September 28, highlighting the $11 charge labelled "Brief Emotion." She added the caption: "Mole removal: $223. Crying: Extra."

By Friday morning, her post had attracted almost 200,000 likes and many shocked comments from social media users.

However, mxmclain has now told Newsweek the bill was for a routine annual examination and "brief emotion" actually referred to a behavioral assessment that was "basically 10 or less questions about mental health."

She said it seemed that the assessment was a normal part of the annual check-up, adding: "I didn't know at the time that it wasn't covered by insurance."

These mental health screenings are "definitely important," she told Newsweek. "But if it's so important it should be fully covered by insurance."

Social media users who saw her initial tweet on Tuesday—particularly those unfamiliar with the costs of the U.S. health care system—reacted with surprise to the idea that a patient might be charged for emotional distress.

One wrote: "This can't be real." Another said: "To think I was just experiencing emotions for free this entire time."

to think i was just experiencing emotions for free this entire time

— sher🥺 (@sherrysworld) September 28, 2021

The assessment appears to be one that is categorized in the health care system as CPT Code 96127 for insurance purposes.

According to an explainer published by the American Academy of Family Physicians, CPT 96127 is a "brief emotional/behavioral assessment" that can be used to screen for conditions such as depression or attention deficit disorder.

The AAFP told Newsweek: "Administration of the assessment is entirely up to the physicians, with patient consent. There are no requirements to screen patients if they display emotion, and Code 96127 cannot be reported simply because a patient shows emotion, such as crying. Any emotional/behavioral assessment based on an encounter is a clinical decision made by the physician in consultation with the patient."

Any qualified health care professional can charge for CPT 96127. The cost varies per insurance company, but the Medicare average was $4.89 per unit as of July 2021, according to ConnectedMind, a mental health screening website.

It is most often a preventative service, but the screening can also be performed as part of an acute illness or follow-up visit, according to a factsheet produced by the Nevada Department of Health and Human Services.

The code "was created in response to the Affordable Care Act's federal mandate to include mental health services as part of the essential benefits that must be included in all insurance plans offered in individual and small group markets," the factsheet said.

Several websites aimed at health care professionals offer advice on how to use CPT 96127 to "get even more" out of basic screening services. TherapyNotes, for example, states that the code can be billed up to four times per client, per session.

Update 10/1/21, 12:10 p.m. ET: This article was updated to add a statement from the American Academy of Family Physicians.

Medical bill
A stock image shows a stethoscope lying on a pile of dollar bills. CPT Code 96127 refers to a mental health screening. Andrii Zorii/Getty