• Jackie Schletter

The Biohazard Fee: Nitpicky or Good Business?

Recently I had a doctor return from an evening of CE and ask me if she should add a biohazard fee to her invoices. For me this is an easy no.

"But we get charged to manage this waste!" the doc says. "Everyone else is doing it". Well, I say let's dare to be different! The best way to grow and care for your practice is to be you, not everyone else.

Here's the thing. Every business across hundreds of disciplines has overhead and what we know as "the cost of doing business". Before making changes to 'cover overhead' I believe we must look at the charge from not only the client's perspective, but from the staff's perspective as well.

Some argue that these fees are warranted to drive revenue and to show the client the value of service. There is an opinion that these fees help the client understand the cost of care, and the carrying costs of the practice. Well I'm here to tell you loud and clear:

Your clients do not care about your cost of doing business.

Simply put, our responsibility as managers and owners is to understand our costs, and price services and product accordingly to generate a profit. I fail to see the logic in targeting a small overhead cost like a biohazard fee for recuperation by asking clients to pay separately for it. When we choose this route, we are also asking staff to have to defend the fee because clients are going to ask. Our veterinary staff spends every day just trying to defend standard of care. Why would we ask them to have to engage in a conversation about a biohazard fee? The fact is many clients will look at this kind of fee as 'nickel and diming'.

If we followed the "pass the fee on" logic, why we wouldn't we charge charge clients an "illumination fee" to light the exam room? How about a "comfort fee" since we have to heat and cool the building? Of course we don't do this - but we do take this overhead into account and "cover" it if you will through our various pricing structures. Almost all of your overhead should be covered by fee structure so clients see an invoice that relates to what happened during their visit.

Should we bury all of our overhead? Absolutely not ... I said almost all! Staff labor is an extremely valid exception. There are times when segregated fees show client's value. Here is the important distinction I consider; Make sure these segregated fees relate to the welfare of your pet.


Be sure you have a surgery line item and charge for monitoring. Let your clients see via billing that a tech and sometimes two were monitoring vitals pre-op and post-op through recovery. This is a conversation worth having with a client should they ask! This fee relates to client pet safety.

If you utilize a therapy laser, charge for more than the fee for the laser. Line item a separate fee for "Certified Laser Technician". This allows us to recover training, ongoing CE, and the time allotted for the therapy. This also indicates to the client that there was certification, adding to the knowledge that your staff wasn't just waving the wand over the pet without specified training. Again, this fee is adding to the practice's bottom line, and serving a higher purpose as it relates to the client's view of the fee.

If you feel the need cover the biohazard fee, increase injection fees, vaccine administration, and anything else that creates the need for the biohazardous waste invoice. Just $.50 or $1 added will amply cover that fee to the practice and never be questioned by a client.

In summary, line item as many fees as you can dream up to keep your bottom line healthy. Just make sure they relate to patient care, are fairly charged, and the staff can explain easily should the line item be questioned.

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